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BANDAGING 


ADAPTED    FOR    SELF-INSTRUCTION. 


By    C.    HENRI    LEONARD,    M.  A.,    M.  D. 


WITH  OVER  ONE-HUNDRED  ILLUSTRATIONS. 


DETROIT: 

DAIT.  Y     POST    BOOK    PRINTING     ESTABLISHMENT. 
1876. 


Entered  according  to  Act  of  Congress,  in  the  year  1875, 

By  C.  HENRI  LEONARD, 

in  the  ofl&ce  of  the  Librarian  of  Congress  at  Washington. 


The  Multum  in  Parvo  Dose  Book. 

BY    C.    HENRI     LEONARD,    M.  A.,    M.  D. 

Second  Edition,  Revised  and  Enlarged.     Paper,  60  cts.;  Cloth,  75  cts. 

Contains  the  doses  of  more  remedies  than  any  other  Dose  Book  or 

Materia  Medica  published,  and  is  used  in  nearly  every  Medical 

College  of  the  United  States,  and  by  Physicians  and  Druggists 

in  every  State  and  Territory,  and  the  Canada s. 

CONTENTS:  Medium  and  maximum  Doses  of  all  officinal  and  nonofficinal  remedies 
and  their  preparations  (emetic  doses  indicated  ,  arranged  in  alphabetical  order  :  Pro- 
nunciation of  each  :  the  Orthography  that  of  the  last  U.  S.  P.  The  nonofficinal  reme- 
dies are  indicated.  Pull  list  of  Preparations,  as  waters,  plasters,  pills,  etc.,  and  pronunci- 
ation. Rules  for  Genitive-case  endings  in  prescription  writing.  A  complete  list  of  I^f- 
. COMPATIBLES  Ditto  of  Polsous  and  their  AntidotE'^,  and  Tests  for  each.  Also  rules  for 
resuscitation  of  the  drowned,  treatment  of  poisoned  wounds,  etc.  Complete  table  of  Tests 
for  Urinary  Deposits,  chemical  and  microscopical.  Full  series  of  Obstetric  Tables,  and 
rules  for  management  in  difficult  cases  and  accidents.  Pronunciation  of  Medico-Biogra- 
phical Names.  Table  of  Fees  for  city  and  country  practice,  taken  from  the  Philadelphia 
Detroit,  and  ^ew  Jersey  lists.  Series  of  Vis^ceral  Measurements  as  guides  for  auscultation 
and  percussion.  The  National  Code  of  Ethics  (condensed),  and  the  Hippocratic  Oath. 
Table  of  the  Exanthemata,  and  differential  diagnosis  Tables  of  Weights,  Measures, 
both  French  and  American,  and  for  apportioning  doses,  etc.  List  of  Abbreviations,  be- 
sides several  pages  of  miscellaneous  matter,  useful  in  emergencies,  accidents,  etc. 

What  THE  Press  say:  "  Is  emphatically  a  multum  in  parvo  *  *  *  and  contains 
a  fund  of  valuable  information  of  every  day  requirement.  *  *  Besides  being  the  most 
complete  Dose  Book  we  knew  of,  it  is  indispensable  to  the  practitioner  on  account  of  its 
other  contents." — Peninsular  Journal  of  Medicine.  "  Every  one  must  acknowledge  that 
this  author  has  compressed  an  immense  amount  of  ready  practical  information  into  the 
minimum  of  space."— CAzca^o  Medical  Journal  and  Examiner.  "Is  just  what  every 
physician  and  druggist  should  have  in  his  pocket  for  immediate  Teterence." —Michigan 
Farmer. 


THE  YEST-POCKET  jlNATOMIST, 

By  C.  HENRI  LEONARD,  M.  A.,  M.  D. 

^Enlarged  Edition — Paper  50  cents.     Used  in  nearly  every  Medical  College  of 
the  United  States. 

CONTENTS ;  Each  Bone  :  its  name ;  pronunciation ;  the  points  of  interest ;  the  num- 
■  ber  and  names  of  muscles  attached  (those  of  insertion  being  indicated  by  different  type); 
number  of  articulations,  and  names  of  bones  articulating;  number  of  developmental 
centers,  and  time  of  first  appearance.  Each  Muscle:  its  name  ;  origin;  insertion  ;  ner- 
vous supply ;  pronunciation,  etc.  Each  Artery  :  its  name ;  number  of  branches,  from 
main  vessel ;  pronunciation  of  each  :  origin  ;  course ;  structures  supplied  ;  anastomosis. 
(Given  in  successive  order  of  origin  ;  the  main  vessels  indicated  by  larger  tpye.)  Each 
VBiNf :  its  name ;  pronunciation ;  course ;  where  emptying ;  vessels  received ;  number  of 
valves  etc.  Each  Nerve  :  its  name ;  pronunciation ;  origin ;  course ;  branches :  distribution  ; 
anastomosis,  etc.  (Main  branches  indicated  by  larger  type.)  Complete  resume  Table 
of  the  bones.    Classified  Table  of  the  actions  of  the  muscles. 

"  Brief,  comprehensible,  and  to  the  point  ;  in  fact  it  is  '  Gray '  and  '  Wilson '    in  a 
"  short  dress."    The  departments  named  are  complete  /  something  you  cannot  say  of  the 
small  anatomies  heretofore  issued." — Medical  Observer. 
I^^Either  book  will  be  sent  post-paid  upon  receipt  of  price  by  addressing  the  Publisher, 

C.  HENRI  LEONARD.  M.  D., 

3SS  Woodward  Avenue,  Detroit,  Mich. 


¥l)e  ">Cultuin  ill  f^kfYo"  ^erie^. 


t  ^  > 


The  Multum  in  Parvo  Dose  Book. 

Paper,  60  cts.     Cloth,  75  cts. 


THE  VEST-POCKET  ANATOMIST. 

Paper,  50  cts. 


MANUAL  OF  BANDAGING 

Fmlly  lll'iiiBtTated, 
Cloth,  $1.50. 


Any  of  the  above  sent  post-paid  upon  receipt  of  price  by 

C.  HENEI  LEONARD,  M.  D., 

Detroit,  Mich. 

R-egu-lar  Discou-iit  to  the  Trade. 


Depots. — Eastern :    D.  Appleton  &  Co.,  New  York  City ;  J.  B.  Lippincott 

&  Co.,  Philadelphia ;  James  Campbell,  Boston.     Southern:  J.P.Morton 

&  Co.,  Louisville.      Western :  Bancroft  &  Co.,  San  Francisco. 


:pi^:hi:f'^^c:h], 


In  the  issue  of  this  httle  Manual  the  author  has  hoped  to 
meet  the  wants  of  many  students  of  medicine,  and  practitioners 
who  have  had  no  opportunities  for  hospital  drill  in  bandaging. 

Our  text-books,  in  general,  are  very  meagre  in  their  descriptions 
and  illustrations  of  this  branch  of  surgery,  and  our  "  Lectures,"  given 
upon  this  topic  at  our  medical  colleges,  are  too  often  cursory  and 
incomplete,  from  the  press  of,  seemingly,  weightier  matters  that 
demand  attention.  We  have,  the  author  believes,  no  work  in  the 
English  language  that  is  devoted  exclusively  to  this  subject. 
Several  works  upon  "  Minor  Surgery,"  in  reprints  and  original 
editions,  are  seen  upon  our  book  shelves ;  yet  even  these  offer  but 
few  descriptions,  and  have  fewer  illustrations — really  the  essential 
part  of  all  treatises  upon  this  art — of  the  various  bandages. 

In  this  work  each  bandage  is  designed  to  have  an  illustration  of 
its  application.  There  are  but  a  few  exceptions  to  this  rule,  and 
these  all  are  either  referred  to  a  wood-cut  that  answers  the  purpose 
sufficiently  well,  or  else  the  bandage  is  so  exceedingly  simple  that 
none  is  required. 

It  will  be  noticed,  also,  that  but  few  "  double-headed  "  bandages 
are  given.  It  has  been  the  purpose  of  the  author  to  omit  these  so 
far  as  possible ;  thus  making  the  book  consist  of  the  simple  and 
more  useful  bandages,  rather  than  those  after  the  "fancy"  and 
ornate  order. 


6  PREFACE. 

A  glance  at  the  Table  of  Contents  will  show  the  extent  of 
ground  gone  over,  and  the  completeness,  or  incompleteness  of  its 
consideration.  "Knots,"  "Poultices,"  "Strappings,"  and  "Immov- 
able Bandages,"  are  so  intimately  connected  with  the  subject  treated 
of  at  length,  that  it  was  thought  advisable  to  introduce  a  iew  short 
chapters  upon  these  topics. 

Gerdy's  classification  has  been,  in  the  main,  followed  for  the 
Roller  bandages,  and  Mayor's  for  the  most  of  the  Triangles  and 
Cravats,  though  the  author  has  adopted  dressings  from  other  sources 
as  well.  He  is  also  under  great  obligations  to  Prof  John  H. 
Lowman,  of  the  Medical  Department  of  the  University  of  Wooster, 
Cleveland,  Ohio,  for  original  matter  and  designs  received,  besides 
many  other  courtesies  extended  to  him. 

Thanking  his  other  various  friends  for  advice  and  assistance 
given,  he  awaits  with  interest  the  Manual's  reception  by  the  medical 
public. 

353  Woodward  Ave,,  .January  1st,  1876.  C.  H.  L. 


OOISTTEHSTTS 


CHAPTEE    I. 

Charpie  and  Cotton-wool  :  A  Plumasseau.  A  Gateau.  A  Boulette.  A 
Boiirdonnet.     A  Tampon.     A  Pelote.     Tents Page  13 

CHAPTER    II. 

CoMPKESSES :  The  Square.  The  Graduated.  The  Triangular.  The  Rectan- 
gular. The  Circular.  The  Complex.  Those  of  Two,  Three,  Four,  and 
Six  Heads.     The  Button-Hole.     The  Perforated Page  16 

CHAPTEE    III. 

Bandages  in  General  :  Maltese  Cross.  A  Eoller.  How  to  Make,  Apply 
and  Confine  a  Eoller Page  19 

CHAPTEE    IV. 

Classification  of  Bandages:  Simple  Bandage.  Compound  Bandage. 
Eegional  Classification Page  24 

CHAPTEE    V. 

Bandages  of  the  Head  :  Skull  Cap.  Circular  of  the  Forehead  and  Eyes. 
Four-tailed  Bandage  of  the  Face.  Fillet  or  Head-band.  Triangle  of  the 
Face.  Cross  of  the  Eye.  Triangle  of  the  Eye.  Cross  of  the  Eyes. 
Fronto-oculo-occipital  Triangle.  Fronto-occipital  Triangle.  Occipito- 
frontal Triangle.  Biparietal  Triangle.  Simple  Cross  of  the  Chin. 
Four-tailed  Bandage  of  the  Chin.  Occipito-mental  Triangle.  Cross  of 
the  Head.  Knotted  Bandage  of  the  Head.  The  T  of  the  Head  and 
Ear.  The  Perforated  T  of  the  Head  and  Ear.  Recurrent  Bandage  of 
the  Head.  Six-tailed  Bandage  of  the  Head.  Triangle  of  the  Head. 
Double  T  of  the  Nose.  T  of  the  Mouth.  Invaginated  Eoller  of  the 
Upper  Lip.  Invaginated  Eoller  of  the  Under  Lip.  Fronto-cervico- 
labial  Triangle.  Invaginated  Triangle  of  the  Under  Lip.  Posterior 
Cross  of  the  Head  and  Neck.  Four-tailed  Bandage  of  the  Head  and 
Neck Page  26 


8  CONTENTS. 

CHAPTEE    VL 

Bandages  of  the  Neck  :  Circular  of  the  Neck.  Cervical  Cravat.  Poste- 
rior Figure  of  8  of  the  Head  and  the  Axilla?  Double  Posterior  T  of 
Head  and  Thorax.  Fronto-dorsal  Triangle.  Anterior  Figure  of  8  of 
the  Head  and  the  Axillae.  Double  Anterior  X  of  the  Head  and  Thorax. 
Occipito-sternal  Triangle.  Figure  of  8  of  the  Head  and  Axilla.  Parieto- 
axillary  Triangle  and  Cravat Page  47 

CHAPTEE    Vn. 

Bandages  of  the  Upper  Extremity  :  Spiral  of  One  Finger.  Posterior 
Figure  of  8  of  the  Thumb  and  Wrist.  Posterior  Figure  of  8  of  the  Hand 
and  Wrist.  Anterior  Figure  of  8  of  the  Hand  and  Wrist.  Four-tailed 
Bandage  of  the  Hand.  Double  T  of  the  Back  of  the  Hand  and  Wrist. 
Single  X  of  the  Back  of  the  Hand  and  Wrist.  Perforated  X  of  the 
Hand  and  Wrist.  Carpo-digito-palmar  Triangle.  Double  Anterior  X 
of  the  Hand  and  Wrist.  Single  Anterior  X  of  the  Hand  and  Wrist. 
Carpo-digito-dorsal  Triangle.  Spiral  of  all  the  Fingers.  Spiral  of  the 
Fingers  and  the  Hand.  The  Sheath  of  the  Fingers.  Figure  of  8  Ex- 
-  tensor  of  the  Hand  upon  the  Forearm.  Figure  of  8  Flexor  of  the  Hand 
upon  the  Forearm.  Carpo-olecranon  Cravat.  Flexor  Carpo-olecranon 
Cravat.  Simple  Spiral  of  the  Forearm.  Eeversed  Spiral  of  the  Superior 
Extremity.  Anterior  Figure  of  8  of  the  Elbow.  Posterior  Figure  of  8 
of  the  Elbow.  Triangle  of  the  Elbow.  Four-tailed  Bandage  of  the 
Elbow.  Cervico-ulnar  Cravat  and  Triangle.  Spiral  of  the  Arm.  Four- 
tailed  Bandage  of  the  Shoulder.  Large  Oblique  Triangle  of  the  Arm 
and  Chest.  Triangular  Front  of  the  Forearm.  Small  Frcnt  of  the 
Hand  or  Forearm.  Posterior  Double  Figure  of  8  of  the  Elbow  and  the 
Opposite  Axilla Page  54 

CHAPTEE    Vni. 

Bandages  of  the  Body:  Spiral  of  the  Chest.  Spiral  of  the  Abdomen. 
Ciicular-quadrilateral  of  the  Chest,  and  Dorsal-cervico-sternal  Triangle. 
Circular-quadrilateral  of  the  Abdomen,  and  the  Dorsal-cervico-sternal 
Triangle.  Circular-quadrilateral  of  the  Thorax  and  Abdomen,  and  the 
Dorsal  Cervico-sternal  Triangle.  Anterior  Thoracico-scapular  Triangle. 
Posterior  Thoracico-scapular  Triangle.  Figure  of  8  of  the  Neck  and 
Axilla.  Cravat  of  the  Neck  and  Axilla.  Figure  of  8  of  the  Shoulder  and 
Opposite  Axilla.  Ascending  Spica  of  the  Shoulder.  Simple  Biaxillary 
Cravat.  Compound  Biaxillary  Cravat.  Cross  of  One  Mamma.  Triangle 
of  the  Mamma.  Bourse  of  ihe  Mamma.  Cross  of  the  Two  Mammae. 
Bimammary  Triangle.  Posterior  Figure  of  8  of  the  Shoulders.  Simple 
Dorsal  Biaxillary  Cravat.  Compound  Dorsal  Biaxillary  Cravat.  Ante- 
rior h  igure  of  8  of  the  Shoulders.  Simple  Sternal  Biaxillary  Cravat. 
Compound  Sternal  Biaxillary  Cravat Page  72 


CONTENTS. 


CHAPTEK    IX. 

Bandages  op  the  Lower  Extremity  :  Figure  of  8  of  One  Toe.  Double 
T  of  the  Toes  and  Ankle.  Spiral  of  All  the  Toes.  Figure  of  8  of  the 
Foot  and  Ankle.  Spiral  of  the  Foot.  Triangle  of  the  Foot.  Four-tailed 
Bandage  of  the  Instep.  Four-tailed  Bandage  of  the  Heel.  Sheath  of  the 
Foot.  Posterior  Figure  of  8  of  the  Knee.  The  Popliteal  Cravat.  An- 
terior Figure  of  8  of  the  Knee.  Cravat  of  the  Knee.  Testudo  of  the 
Knee.  Spiral  of  the  Knee.  Four-tailed  Bandage  of  the  Knee.  Simple 
Spiral  of  the  Leg.  Spiral  of  the  Thigh.  Eeversed  Spiral  of  the  Leg. 
Keversed  Spiral  of  the  Thigh.  Figure  of  8  Spiral  of  the  Extremities. 
Figure  of  8  Bandage  of  the  Extremities.  Triangle  of  the  Leg.  Four- 
tailed  Bandage  of  the  Leg.  Keversed  Spiral  of  the  Inferior  Extremity. 
Recurrent  for  an  Amputated  Thigh,  etc.  Triangle  for  Thigh  Stump, 
etc.  Maltese-cross  for  Thigh-stump,  etc.  Caputina.  Tarso-patellar 
Cravat.  Tarso-crural  Cravat.  Tarso-pelvic  Cravat.  Scapulo-tibial 
Triangle  and  Cravat.  Sling  of  the  Lower  Extremity.  Cross  of  the 
Groin.  Descending  Spica  of  the  Groin.  Trapezoidal  T  of  the  Groin. 
Cruro-inguinal  Triangle.  Cruro-pelvic  Triangle.  Cruro-pelvic  Cravat. 
Sacro-bicrural  Cravat.  Double  X  of  the  Perinseum.  Single  T  of  the 
Perinaeum.  Perinseal  Cravat.  Sacro-pubic  Triangle.  Four -tailed 
Bandage  of  the  Hip.  Coxo-pelvic  Triangle.  Lumbo-scrotal  Triangle. 
Bourse  of  the  Scrotum.     Double  T  of  the  Trunk Page  86 

CHAPTER    X. 

Immovable  Dressings:  The  Bavarian  Plaster  Splint.  The  Common 
Plaster  Dressing.  Starch,  or  Plaster,  EoUer.  The  Silica  Bandage.  The 
Parrafin  Bandage.     Fenestrated  Immovable  Dressings.      .     .     Page 

CHAPTER    XL 

Strappings:  For  the  Foot  and  Ankle.  For  wounds.  For  a  Testicle.  For 
the  Breast.     For  Extension  of  the  Leg, Page 

CHAPTER    XIL 

Knots:  The  Surgeon's  Knot.  The  Reef  Knot.  The  Clove-hitch  Knot. 
Gerdy's  Extension  Knot Pao-e 

CHAPTER    XIIL 

Oataplasmata  :  Cataplasma  Carbonis.  Cataplasma  Conii.  Cataplasma 
Fermenti.  Cataplasma  Lini.  Cataplasma  Sinapis.  Cataplasma  Soda? 
Chlorinatae.     Cataplasma  Panis  et  Lactis.     Oakum  Poultice.     How   to 

Spread  a  Poultice.     How  to  Apply  a  Poultice Page 

2 


LIST    OIF-    irjLTJSTI^_A.TIOlNr©. 


> » 


Figure.  page. 

1  Perpendicular  section  of  a  Graduated  Compress,      .         .         .         .  1& 

2  Compress  of  Two  Heads,        .         .         .         .         .         .         .         .  17 

3  Compress  of  Three  Heads, .  17 

4  Compress  of  Four  Heads,       ........  17 

5  Button-hole  Compress, 18 

6  Perforated  Compress, 18 

7  Maltese  Cross, .20 

8  A  Eoller, 20 

9  How  to  make  a  Roller-head, 21 

10  Applying  a  Holler,         .         . 22 

11  Confining  a  Roller,    . 23 

12  Circular  of  Forehead  and  Eyes,     .......  26 

13  Fillet  or  Head-band, 27 

14  Cross  of  the  Eye, 28 

15  Cross  of  the  Eyes, 29 

16  Fronto-oculo-occipital  Triangle, 30 

17  Fronto-occipital  Triangle, 31 

18  Simple  Cross  of  the  Chin,      ........  32 

19  Four-tailed  Bandage  of  the  Chin, 33 

20  Occipito-mental  Triangle, 34 

21  Cross  of  the  Head, 35 

22  Knotted  Bandage  of  the  Head, 36 

23  The  T  of  the  Head  and  Ear, 37 

24  Perforated  J  of  the  Head  and  Ear, 38 

25  Recurrent  Bandage  of  the  Head, 39 

26  Diagram  of  the  Six-tailed  Bandage  of  the  Head,  ...  40 

27  Six-tailed  Bandage  of  the  Head, 40 

28  Triangle  of  the  Head, 41 

29  Double  T  of  the  Nose, 42 

30  T  of  the  Mouth, 43 

31  Invaginated  Roller  of  the  Upper  Lip,      ......  44 

32  Fronto-cervico-Iabial  Triangle, 45 


MANUAL   OF  BANDAGING.  11 

FIGURE.  •  PAGE. 

33  Posterior  Cross  of  the  Head  and  Neck, 46 

34  Posterior  Figure-of-8  of  the  Head  and  Axillje,     .         .         .         .  •  48 

35  Double  Anterior  T  of  the  Head  and  Thorax,  .         .         .         .50 

36  Occipito-sternal  Triangle,      .         .         .         .         .         .  '       .         .  51 

37  Figure-of-8  of  the  Head  and  Axilla, 52 

38  Parieto-axillary  Triangle  and  Cravat, 53 

39  Spiral  of  One  Finger, 54 

40  Posterior  Figure-of-8  of  the  Thumb  and  Wrist,   ....  55 

41  Posterior  Figure-of-8  of  the  Hand  and  Wrist,          .         .         .         .  56 

42  Diagram  for  Double  T  of  the  Back  of  the  Hand  and  Wrist,       .  57 

43  Double  T  of  the  Back  of  the  Hand  and  Wrist,       ....  58 

44  Diagram  of  the  Perforated  T  of  the  Hand  and  Wrist,         .         .  59 

45  Perforated  T  of  the  Hand  and  Wrist, 59 

46  Carpo-digito-palmar  Triangle, 60 

47  Spiral  of  All  the  Fingers, 61 

48  Spiral  of  the  Fingers  and  the  Hand, 62 

49  Figure-of-8  Extensor  of  the  Hand  upon  the  Forearm,     .         .         .63 

50  Carpo-olecranon  Cravat,        ........  64 

51  Anterior  Figure-of-8  of  the  Elbow, 66 

52  Cervico-ulnar  Cravat  and  Triangle, 67 

53  Large  Oblique  Triangle  of  the  Arm  and  the  Chest,  .         .         .68 

54  Triangular  Front  of  the  Forearm, 69 

55  Small  Front  of  the  Hand  or  Forearm, 70 

56  Posterior  Double  Figure-of-8  of  the  Elbow  and  Opposite  Axilla,  70 

57  Spiral  of  the  Chest, 72 

58  Circular-quadrilateral   of  the   Chest,    and   Dorsal   Cervico-sternal 

Triangle, 73 

59  Anterior  Thoracico-scapular  Triangle,           .         .         .         .         ,  74 

60  Figure-of-8  of  the  Neck  and  Axilla, 75 

61  Figure-of-8  of  the  Shoulder  and  Opposite  Axilla,         ...  76 

62  Simple  Biaxillary  Cravat, 77 

63  Compound  Biaxillary  Cravat, 78 

64  Cross  of  One  Mamma, 78 

65  Triangle  of  the  Mamma, 79 

66  Diagram  of  the  Bourse  of  the  Mamma, 79 

67  Bourse  of  the  Mamma, 80 

68  Cross  of  the  two  Mammte, SO 

69  Posterior  Figure-of-8  of  the  Shoulders, 81 

70  Simple  Dorsal  Biaxillary  Cravat, 82 

71  Compound  Dorsal  Biaxillary  Cravat, 83 

72  Anterior  Figure-of-8  of  the  Shoulders, 84 

73  Figure-of-8  of  the  Foot  and  Ankle, 87 


12  LIST    OF  ILLUSTRATIONS. 

FIGURE.  PAGE. 

74  Triangle  of  the  Foot, 88 

75  Posterior  Figure-of-8  of  the  Knee,        ......         89 

76  The  Popliteal  Cravat, 90 

77  Testudo  of  the  Knee, 91 

78  Four-tailed  Bandage  of  the  Knee,    . 92 

79  Figure-of-8  Spiral  of  the  Extremities, 93 

80  Figure-of-8  Bandage  of  the  Extremities, 94 

81  Triangle  of  the  Leg, 95 

82  Reversed  Spiral  of  the  Inferior  Extremity,      .         .         .         .         .96 

83  Eecurrent  for  Amputated  Thigh, 97 

84  Triangle  for  Thigh  Stump, 98 

85  Maltese-cross  for  Thigh  Stump, 98 

86  Diagram  for  Caputina, 99 

87  Caputina  Applied, .       100 

88  Tarso-patellar  Cravat, 101 

89  Scapulo-tibial  Triangle  and  Cravat, 102 

90  Sling  of  the  Lower  Extremity, 103 

91  Cross  of  the  Groin, 103 

92  Trapezoidal  T  of  the  Groin,     . 104 

93  Cruro-iuguinal  Triangle, 105 

94  Cruro-pelvic  Cravat,  .         .         .         .         .         .         .         .         .106 

95  Sacro-bicrural  Cravat,    . 106 

96  Double  T  of  the  Perineum, 107 

97  Sacro-pubic  Triangle,    ...  108 

98  Coxo-pelvic  Triangle, .         .         .109 

99  Lumbo-scrotal  Triangle,         .         .         .        ' 109 

100  Bourse  of  the  Scrotum.      .         .         .  .         .         .         .         .110 

101  Double  T  of  the  Trunk, Ill 

102  The  Bavarian  Plaster  Splint, 113 

103  Strapping  for  the  Foot  and  Ankle, 118 

104  Strapping  for  Superficial  Cuts, 119 

105  Strapping  for  Deep  Cuts, 119 

106  Strapping  for  a  Testicle, 120 

107  Strapping  for  Extension  of  the  Leg,      ......       122 

108  (a)  The  Surgeon's  Knot,     (b)  The  Eeef  Knot,        ....  123 

109  The  Clove-hitch  Knot, 124 

110  M.  Gerdy's  Extension  Knot, 125 


A  MANUAL  OF  BANDAGING. 


CHAPTER     I. 

CHARPIE — COTTON-WOOL. 

Of  this  there  are  four  kinds  :  viz.,  raw^  long,  rasped  and  web-like. 
But  one  of  these,  the  raw,  is  of  moment. 

This  is  made  by  picking  apart  the  threads  of  a  piece  of  linen, 
each  filament  having  a  length  from  2  to  3  inches  ;  if  they  are  too 
short  the  filaments  are  apt  to  mat  or  lump  together,  and  so  render 
it  unfit  for  the  uses  for  which  it  was  intended.  A  good  article  should 
be  white,  soft  and  light,  and  somewhat  elastic. 

The  difficulty  of  procuring  a  properly  prepared  charpie,  and  of 
keeping  it  free  from  mattings  has,  at  present,  induced  most  surgeons 
to  substitute  for  it  clean  cotton-wool. 

Charpie,  or  cotton-wool  is  used  in  surgery  to  protect  from  irrita- 
tion, to  compress,  and  to  slightly  irritate,  as  well  as  to  maintain  in 
equal  temperature  a  wounded  member :  one  of  its  most  common 
uses  is,  however,  as  an  absorbent  of  the  secretions  from  a  wounded 
surface.  For  these  multitudinous  uses  it  is  employed  under  the 
forms  oi plumasseaux,  gateaux,  botdettes,  bourdonnets,  tampons,  pelotes, 
and  layers  or  lamificz. 

A  Plumasseau  (a  pledget) — is  but  a  bunch  of  charpie  which 
has  been  drawn  lengthwise  lightly  through  the  fingers  till  the  fila- 
ments of  the  mass  are  made  parallel  with  each  other,  and  the  mass 
made  of  the  same  thickness  and  density  throughout.  It  may  be  used 
as  an  absorbent  of  secretion,  for  slight  compression,  or  for  carrying 
medicaments  to  a  wounded  surface. 

A  Gateau  (a  cake) — is  nothing   more    or  less  than   a  large 
plumasseau,  with  the  ends  of  the  charpie  folded  into  the  centre  of 
3 


14  CBARPIE— COTTON-WOOL. 

the  mass.     Is  used  more  especially  for  compression  and  for  absorb- 
ing the  secretions  from  a  wound. 

A  Boulette  (a  little  ball) — is  simply  a  ball  of  charpie  formed 
by  rolling  little  masses  of  it  in  the  palms  of  the  hands.  They  should 
be  soft,  elastic  and  loosely  made.  Are  used  for  cleansing,  or  as 
carriers  of  sundry  medicaments. 

A  Bourdonnet  (a  dossil  or  lu^np  of  lint) — is  a  small  plumas- 
seau  tied  closely  around  the  middle,  giving  it  an  hour-glass  shape. 
Used  as  a  compress  or  as  a  slight  tampon  in  cases  of  hemorrhage. 

Tampon  (a  plug) — is  a  large  bourdonnet  and  prepared  in  the 
same  manner  as  the  preceding.  Other  forms  and  varieties  are  in 
use;  as  the  vaginal,  rectal,  etc.  The  two  latter  are  perhaps  prepared 
best  from  pieces  of  lint  3  or  4  inches  square,  soaked  in  water,  then 
introduced  singly,  and  "crowded  closely  home."  Sometimes,  as  in 
lithotomy,  wounds  of  the  rectum,  etc.,  we  wish  to  make  strong 
lateral  compression ;  here  use  a  tampon  formed  over  a  female  (metal) 
catheter,  by  fastening  the  slotted  end  of  the  instrument  securely  to 
the  center  of  a  piece  of  lint  8  or  10  inches  square  ;  introduce  this 
into  the  wound,  retaining  the  corners  of  the  lint  at  the  surface. 
When  introduced,  pack  your  charpie,  or  lint,  or  cotton-wool,  closely 
around  the  shaft  of  the  catheter,  between  it  and  the  surrounding 
piece  of  lint,  till  you  get  the  requisite  amount  of  compression.  This 
form  of  a  tampon  can  be  successfully  used  in  these  cases,  as  the  lint 
(fastened  to  the  catheter)  prevents  the  escape  of  the  charpie,  or  other 
packing  substance,  up  the  gut  (in  the  case  of  rectal  use),  or  beyond 
the  point  where  pressure  is  desired  to  be  made. 

A  Pelote  (a  ball,  or  pin-cushion) — is  formed  by  tying  firmly  a 
wisp  of  charpie  in  a  piece  of  lint,  giving  it  something  the  shape  of  an 
old-fashioned  pin-cushion,  as  made  over  a  broken  lamp-stand.  Uses ; 
bound  over  the  course  of  an  artery,  it  serves  to  arrest,  for  the  time 
being,  the  flow  of  blood  through  it.  It  also  serves  the  purpose  of  a 
tampon  in  certain  cases  of  htemorrhage. 

Tents — have  also  been  made  of  charpie  by  taking  the  long 
fibres  of  it,  doubling  in  the  middle,  and  then  crowding  it  into  the 
wound.     But  in  our  day  of  sponge  tents,  and  the  laminaria  digitata^ 


MANUAL   OF  BANDAGING.  15 

such  a  use  of  it  will  not  be  thought  of  save,  in  a  case  of  emergency, 
when  the  manufactured  tents  are  not  at  hand. 

The  most  of  the  above  articles  of  dressing  are  now  made  from 
what  is  generally  known  as  "surgeon's  lint"  (see  Chapter  II). 
Still,  some  surgeons  prefer  the  charpie,  or  even  oakum  dressing,  to 
any  other. 


16-  comphesses. 


CHAPTER    II. 

OF  COMPRESSES. 

These  are  best  made  of  the  "  surgeon's  Hnt "  cloth,  it  giving  a 
more  smooth,  even  and  regular  pressure.  Their  forms  and  sizes 
are  almost  innumerable,  the  surgeon  using  what  the  exigencies  of 
the  case  may  demand ;  yet  the  following  brief  classification  may 
prove  of  service.     We  start  with  the  most  simple  : 

The  Square. — Its  name  indicates  its  peculiarity  of  form ;  it 
may  be  of  a  rectangular  piece  of  the  ''surgeon's  lint,"  folded  in  the 
middle  to  make  a  square,  thus  being  double  thickness,  or  it  may  be 
built  of  a  succession  of  smaller  pieces  to  a  pyramidal  form,  forming 
the  graduated  pyramidal  compress.  If  each  successive  piece  is  of  the 
same  size  as  the  first,  it  forms  the  graduated  regular  compress.  In 
either  of  the  two  latter  forms,  it  should  be  stitched  through  and 
through,  in  two  or  three  places,  so  as  to  prevent  the  pieces  becoming 
displaced. 

Perhaps  as  simple  a  way  of  forming  a  graduated  compress  is  the 
following :  cut  quite  a  long  piece  of  the  "  lint "  of  the  width  of  the 
compress  desired,  then  placing  one  end  of  the  fragment  flatwise  on 
the  table  to  the  extent  of  the  size  wanted  in  a  longitudinal  direction, 
fold  it  over  upon  itself,  reversing  the  motion  of  the  hand,  till 
you  reach  the  initial  edge  of  the  first  layer ;  here  fold  over  again,  re- 
versing the  motion  of  the  hand,  and  so  on.  Fig.  i  will  give  an  idea 
FIG.  I.  of  the   manoeuvres    indicated,    as    the 

compress  is  seen  on  an  exaggerated 
perpendicular  section,  a  is  the  initial, 
B,  the  final  end.  In  this  case  some 
stitches  will  be  needed  to  confine  the 
folds  securely. 

The  Triangular  and  Rectangular  are  but  modifications  of 
the  above,  and  need  no  further  description. 

The  Circular  is,  as  its  name  indicates,  a  circular  piece  of 
"  surgeon's  lint."  We  have  three  varieties  of  the  circular  compress  : 
I  St,  the  clipped;  2d,  \he  perforated ;  and  3d,  \ht  graduated.    The  first 


MANUAL   OF  BANDAGING.  17 

is  the  ordinary  kind,  the  edges  being  clipped  inwards  to  a  sufficient 
extent  that  it  may  lie  smoothly  on  a  part.  The  second  variety  admits 
of  any  modification  desirable  in  the  position,  form  or  extent  of  punc- 
ture or  cut.  The  third  is  essentially  formed  in  the  same  manner  as 
the  others  of  its  class. 

The  Complex. — Under  this  head  all  perforated  and  fenestrated 
compresses,  and  those  of  two  or  more  heads,  are  meant  to  be  in- 
cluded, whether  they  be  rectangular  or  square. 

A  Compress  of  Two  Heads  is  simply  a  common  compress 
with  one  end  split  at  the  centre  as  you  see  in  Fig.  2. 

FIG.   2.  FIG.   3.  FIG.   4, 


One  of  Three  Heads. — A  common  compress  with  one  end 
split  into  three  equal  or  unequal  parts,  as  seen  in  Fig.  3. 

A  Sling  Compress  is  a  common  compress  having  each  end 
split  at  the  middle,  as  seen  in  Fig.  4.  It  is  also  known  as  a  compress 
of  four  heads. 

A  Compress  of  Six  Heads. — This  is  a  compress  similar  to 
one  of  three  heads ;  the  difference  being  that  both  ends  are  split  into 
three  equal  or  unequal  parts. 

The  Button-hole  Compress  is  one  that  has  two  or  more 
sUts  through  its  centre,  as  seen  in  Fig.  5. 

The  Perforated  Compress  is  one  that  has  been,  as  its 
name  implies,  filled  with  small  perforations,  either  by  means  of  a 
stylet,  or  small  punch,  or  by  having  pieces  snipped  out  by  the  scis- 
sors. Fig.  6  will  give  you  an  idea  of  this.  Is  especially  useful  as  a 
dressing  for  di.  freely  suppurating  surface. 


18 


COMPBESSES. 


FIG.   6. 


The  Uses  of  these  various  compresses  are  still  more  varied  than 
their  multiplicity  of  forms.  The  demands  of  the  case  must  be  met 
by  the  ingenuity  of  the  surgeon  in  devising  something  appropriate ; 
and,  having  a  knowledge  of  these  more  generally  used  forms,  he  can 
choose  the  one  that  will  be  most  subservient  to  his  purpose,  or  mo 
dify  it  to  suit  the  exigencies  of  his  case. 


MANUAL  OF  BANDAGING.  19 


CHAPTER    III. 

ON    BANDAGES    IN    GENERAL. 


Hippocrates  has  said  that  in  bandaging  there  is  a  two-fold  pur- 
pose to  be  kept  in  view;    viz.:   " that  which  regards  it  while  doing, ~ 
and  that  which  regards  it  when  done.     It  should  be  done  quickly  j 
without  pain,  with  ease,  and  with  elegance ;  quickly,   by  dispatching  > 
the  work  ;  without  pain,  by  being  readily  done ;  with  ease,  by  being  I 
prepared  for  everything ;  and  with  elegance,  so  that  it  may  be  pleasing  J 
to  the  sight." 

There  could,  perhaps,  be  no  more  terse  and  comprehensive  rules 
to  be  kept  in  mind  as  regards  bandaging,  than  those  offered  by  that 
great  medical  sage  nearly  twenty-five  hundred  years  ago.  And  yet 
how  often,  in  the  drill  our  students  receive  in  their  class-rooms,  has 
this  exercise  been  deficient  both  in  the  teacher  and  in  the  taught. 
Yet,  to  the  surgeon,  a  smoothly,  rapidly  applied  bandage,  aside  from 
its  extreme  usefulness,  has  an  element  of  beauty  about  it  that  is  not 
readily  forgotten.  It  begets  confidence,  too,  in  your  patient,  in  his 
friends,  and  adds  greatly  to  your  professional  reputation.  Hippocrates 
appreciated  this,  and  instructed  his  pupils  thoroughly  in  the  minutiae 
of  the  art.  To-day  it  is  almost  wholly  neglected,  and  even  if  spoken 
of  at  all,  is  dismissed  as  hurriedly  as  possible  from  the  thoughts  of 
faculty  and  students. 

Hippocrates  further  adds  :  "  The  form  of  the  bandage  should  be 
suitable  to  the  form  and  affection  of  the  part  to  which  it  is  applied. 
The  force  of  the  constriction  should  be  such  as  to  prevent  the  ad- 
joining parts  from  separating,  without  compressing  them  much,  and 
so  that  the  parts  may  be  adjusted  and  not  forced  together."  He 
further  adds,  after  treating  of  the  subject  quite  exhaustively,  that  "the 
bandages  should  be  clean,  light,  soft  and  smooth.  The  heads  of  the 
bandages  should  be  hard,  smooth  and  neatly  put  on."  This,  coming 
from  such  antiquity,  and  agreeing  with  the  hospital  experiences  of 
the  last  twenty-three  hundred  years  should  be  enough  to  recommend 
it  to  your  most  earnest  consideration. 


20 


BANDAGES  IN  GENERAL. 


The  Maltese  Cross. — This  is  formed  from  a  square  piece  of 
surgeon's  lint,  by  cutting  up  from  each  corner  two-thirds  of  the  way 
toAvards  the  centre  of  the  piece,  giving  you  when  completed  the  form 
FIG.  7.  seen  in  Fig.  7.     Another  way  of  forming  it 

is,  to  double  the  square  piece  of  lint  at  its 
middle,  then,  transversely  to  this  fold,  double 
it  over  again ;  this  gives  you  four  thicknesses 
of  the  lint.  This  done,  cut  diagonally  across 
this  small  square,  to  a  distance  of  two-thirds 
of  the  length  of  the  diagonal,  beginning  at 
the  four  free  corners  of  the  folded  lint.  On 
unfolding,  you  wiU  find  you  have  a  regularly  and  evenly  made  cross 
of  this  pattern. 

Uses. —  Most  generally  employed  in  stump-  and  joint-dressings, 
as  it  readily  adapts  itself  to  all  convex  surfaces,  the  corners  smoothly 
folding  over  each  other,  as  it  is  applied. 

A  Roller- — -is  the  term  given  to  our  common  narrow  bandage ; 
probably  because   to   be   used,    it    must    first    have   been   rolled 

smoothly  and  nicely  up.  Fig.  8 
shows  you  the  bandage,  or  rol- 
ler, as  ready  for  use.  The  part 
A  is  known  as  the  head ;  the  part 
B  as  the  initial  end.  Figure  8  is 
therefore  a  roller  with  one  head, 
and  is  classed  as  a  simple  bandage. 

Rollers  may  be  of  either  one  or  two  heads,  at  pleasure.  In  case 
of  the  latter  the  second  head  is  formed  by  rolling  up  the  initial  end 
(b,  in  the  cut)  the  same  as  the  head  a  has  been  rolled.  However,  as  a 
double-headed  has  no  advantage  over  the  single-headed  roller,  save  in 
the  bandage  known  as  "  the  recurrent  of  the  head,"  and  a  few  others, 
I  shall  dismiss  it,  with  but  few  exceptions,  from  the  work.  A  single- 
headed  roller  is  much  more  easily  appHed,  looks  just  as  well,  and,  in 
most  cases,  even  answers  the  purpose  better. 

Our  single-headed  roller  has,  then,  besides  the  initial  end  and 
head,  z.  plane,  c;  an  internal  surf  ace,  Cj  dcn.  external  surface;  d,  superior 
and  an  inferior  border. 


MANUAL  OF  BANDAGING.  21 

How  to  make  a  Roller. — Rollers  are  generally  made  of  flan- 
nel. In  some  delicate  operations  where  "  heating  "  of  the  wound,  or 
the  contiguous  surface,  is  feared,  linen  or  cotton  has  taken  its  place. 
The  two  latter  substances  never  apply  so  evenly  or  smoothly  as  the 
flannel,  as  there  is  little  or  no  elasticity  in  them.  •  On  the  contrary, 
both  edges  of  a  flannel  roller  will  lie  smoothly  upon  a  part  if  proper- 
ly applied — a  result  difficult  to  be  obtained  on  the  use  of  a  linen  or 
cotton  roller ;  that  is,  if  the  surface  be  anywise  irregular  or  uneven. 
Farther  than  this,  the  stimulus,  from  pressure  to  a  part,  that  flannel 
often  gives,  through  its  quality  of  elasticity,  is  a  great  desideratum  in 
most  cases  that  require  a  bandage.  Then,  too,  if  the  part  should 
swell,  the  bandage  gives ;  if  the  swelling  be  reduced,  the  bandage,  in 
great  measure,  accommodates  itself  to  this  change,  "  support "  thus 
being  continually  kept  up ;  two  other  important  qualities  that  are 
lacking  in  the  linen  or  cotton  roller.  Of  course  the  two  latter  have  a 
plea  of  "  cheapness," — of  doubtful  consideration,  however,  when  the 
comfort  (present  and  future)  of  the  patient  is  at  stake. 

The  flannel  having  been  torn  into  proper  strips,  as  regards 
length  and  width,  one  end  is  taken  and  doubled  over  eight  or  ten 
inches  upon  itself ;  this  doubled  portion  again  doubled  upon  itself, 
and  this  again  upon  itself,  until  it  is  in  proper  shape  for  "rolling,"  or 
winding.  This  is  started  by  gently  rolling  the  doubled  portion  be- 
tween the  palm  of  the  hand  and  table,  or  knee,  as  the  case  may  be, 
until  three  or  four  turns  are  taken  ;  then  the  roll  is  grasped  between 
the  thumb  and  forefinger  (the  second  finger  assisting,  if  need  be)  of  the 
left  hand,  the  external  surface  (Fig.  8)  of  the  bandage  being  up.  The 
unwound  portion  is  grasped  by  the  right  hand  and  allowed  to  fall  in 
between  the  thumb  and  forefinger,  as  seen  in  Fig.  9.  (Some  surgeons 
^i<^-  9.  prefer  to  have  it  fall  in  between 

the  first  and  second  fingers,  the 
I  thumb  crowding  in  closely  to  the 
"head"  of  the  bandage.)  This 
I  done,  holding  the  bandage  quite 
firmly,  yet  loosely  enough  to  slip, 
between  the  thumb  and  finger, 
I  the  thumb  hugging  tightly  the 
head",  by  a  downward  or  supine  motion  of  the  right  hand,  you 


22  BANDAGES  IN  GENERAL. 

partially  circle  the  forming  roller-head,  the  ring-tinger  sliding  over  it 
as  a  guide.  This  done,  grasp  the  roller-head  firmly  with  the  right 
hand  (by  pressing  it  against  the  ball  of  the  thumb  with  the  second 
and  third  fingers),  pronate  the  hand  as  far  as  possible,  then  confide 
the  grasp  of  the  roller-head  to  the  thumb  and  fingers  of  the  left  hand 
to  go  through  with  the  same  manoeuvres  as  before.  In  all  of  these 
motions  the  left  hand  is  to  be  perfectly  immovable,  the  right  per- 
forming all  the  work,  save  the  simple  holding  of  the  roller-head 
when  the  right  is  making  its  supination  around  it.  Although  beginning 
these  motions  slowly,  you  can  soon  increase  their  rapidity  until  you 
can  "  roll "  a  bandage  with  surprising  quickness.  As  soon  as  the 
"catch"  to  it  is  mastered,  it  is  easily  and  rapidly  done. 

How  to  Apply  a  Roller. — To  be  appHed  easily  it  must  be 
wound  evenly  and  tightly.  Hippocrates  said,  "  the  turns  of  a  band- 
age should  be  made  firom  right  to  left,  and  left  to  right,  except  on 
the  head,  where  they  should  be  in  a  straight  or  vertical  direction."  I 
would  simplify  this  by  allowing  the  surgeon  to  suit  his  own  con- 
venience, remembering  only  to  place  the  external  surface  of  the  ini- 
tial end  to  the  part  to  be  bandaged.  This  done,  press  it  firmly  with 
the  fingers  of  the  left  hand  to  the  member;  the  right  hand  grasps  the 
roller-head  tightly  between  the  thumb  and  first  and  second  fingers, 
and  carries  it  firmly  down  and  around  the  member  (letting  it  slowly 
unwind)  as  far  as  possible ;  then  grasping  it  with  the  left  hand,  the 
thumb  of  the  right  confining  the  initial  end,  complete  the  turn,  over- 
lapping the  initial  end  completely  or  partially,  as  you  see  in  turns  i 
and  2  in  Fig.  lo.  Make,  then,  one  or  two  circular  turns,  as  3  and 
FIG.  10.  4,  firmly  and   evenly  sweeping  around  the 

limb,  each  overlapping  the  preceding  course 
about  one-third  the  width  of  the  bandage. 
"The  reverses"  \i\i\Q}i\  should  always  be  made 
whenever  the  part  to  be  bandaged  assumes 
anything  of  a  pyramidal  or  conoidal  contour, 
as  they  keep  the  bandage  firom  slipping  down, 
are  formed  by  pressing  the  first  and  second 
fingers  firmly  upon  the  superior  border  of  the 
bandage  at  the  point  where  the  reverse  is  to 
be  made,  thus  securing  the  bandage ;  then, 
making  a  slack  motion  of  the  right  hand,  turn 


MANUAL   OF  BANDAGING.  23 

the  bandage  over  eftd  for  end,  by  the  right  hand  fingers,  and  bring 
what  was  the  suj>erior  border  of  the  bandage  down  to  the  top  of  the 
left  hand's  finger,  or  fingers  that  are  confining  the  bandage ;  you  thus 
make,  an  inferior  of  what  was  the  superior  border.  Each  succeeding 
reverse  is  to  be  made  in  the  same  way.  There  is  also  a  "catch"  to  this, 
although  simple  as  it  may  seem,  that  only  repeated  trials  will  enable 
you  to  become  master  of  The  main  points,  however,  to  bear  in 
mind,  are  :  ist.  Keep  the  bandage  always  tight  and  with  equal  ten- 
sion at  every  turn.  2d.  Bring  it  up  somewhat  diagonally,  before 
making  the  reverse,  and  carry  it  down  diagonally  (the  opposite  of  the 
other)  after  the  reverse  is  made,  as  you  see  in  the  figure.  3d.  Always 
have  the  edges  of  the  overlapping  turn  as  nearly  equal  all  around 
as  possible ;  this  is  best  done  by  keeping  a  "  close  eye "  upon 
the  upward  and  downward  motions  of  the  roller-head,  and  after  a 
time  this  will  be  done  unconsciously.  The  first  few  applications  of 
a  reversed  roller  should  always  be  slowly  and  pains-takingly  made, 
that  your  hands  may  not  learn  some  bad  tricks  that  must  be  un- 
learned them  before  they  will  apply  one  smoothly  and  nicely.  Festina 
lente  is  a  good  motto  in  bandaging. 

How  to  Confine  a  Roller. — ^To  confine  a  roller  properly  is  a 
nice  point  in  the  application  of  such  a  surgical  dressing,  although  it 
is  a  manoeuvre  that  is  too  often  clumsily  and  imperfectly  made. 

On  reaching  the  terminal  end  of  your  bandage,  always  fold  under 
the  edges  of  the  end,  so  as  to  bring  it  to  the  shape  seen  in  Fig.  11. 
FIG-  11. Then,  introduce  your  pin  (riot  per- 
pendicularly but)  in  a  direction  con- 
trary to  the  course  of  the  bandage, 
as  you  see  in  the  wood-cut.  By  so 
doing  you  will  have  it  smoothly  and 
securely  confined.  If  the  roller  be  very  wide,  two  pins  may  be  neces- 
sary. The  "  strain  "  on  the  bandage  thus  serves  only  to  draw  the 
pin  into  its  place,  and  no  ordinary  amount  of  friction  from  the  bed- 
clothes or  wearing  apparel  will  loosen  it. 


24  CLASSIFICATION  OF  BANDAGES. 


CHAPTER    IV. 

CLASSIFICATION    OF    BANDAGES. 

In  olden  times  bandages  received  their  names  from  four  sources. 
\iz.  :  I  St.  Their  authors.  2d.  Their  forms.  3d.  Their  uses.  4th. 
From  some  fancied  resemblance  to  some  article,  or  manoeuvre. 

Thus  we  have  the  Hippocratic  rhomb;  the  crooked  nose;  the 
hare;  the  quadriga,  etc.,  as  epidetic  terms  frequently  to  be  met  with 
on  perusal  of  old  authors.  Nothing  like  a  classification  proper  was 
attempted  by  them.  Coming  nearer  to  our  own  time  an  attempt  was 
made  to  put  them  all  under  the  heads  of  their  uses  ;  such  as  "  com- 
pressive," "retentive,"  "reductive,"  etc.  But  this  utterly  failed,  as 
almost  any  bandage  could  be  used  for  any  of  the  special  purposes 
for  which  the  others  were  employed.  Gerdy  finally  brought  for- 
ward his  system,  that  of  referring  all  to  some  general  figure,  as 
"cross,"  "  circular,"  "  spiral,"  "  figure  of  8,"  etc.,  adding  as  a  generic 
cognomen  the  part  to  which  it  was  applied ;  as  "  cross  of  the  eye  " ; 
"  cross  of  the  head"  ;  "  spiral  of  the  finger  " ;  "  figure  of  eight  of  the 
chest,"  etc.  Mayor  then  introduced  his  system  of  triangular  and 
quadrilateral  bandaging,  naming  them  from  the  anatomical  part  to 
which  they  were  applied ;  a  double  name,  in  fact,  the  first  being  the 
part  whereat  the  base  of  his  triangle  was  applied,  the  other  around 
or  over  which  the  ends  were  passed  and  fastened,  e.  g.;  "  occipito- 
frontal"  would  indicate  that  the  base  of  his  triangle  was  at  the 
occiput,  and  the  two  ends  of  the  triangle  had  been  passed  around 
and  tied  at  the  forehead.  This  latter  system  of  nomenclature  is 
really  the  more  scientific ;  but  it  is  hardly  convenient  to  adapt  it  to 
our  roller  bandaging,  the  system  most  universally  employed.  The 
system  of  triangles  and  quadrilaterals  of  Mayor,  though  very  con- 
venient, will  hardly  come  into  general  use,  as  it  is  impossible  to  get 
so  smooth  and  nicely  adjusted  a  triangle  as  a  roller.  In  some  cases, 
as  for  instance  that  of  an  exigency,  it  is  well  to  understand  his 
system ;  as  by  that  you  can  adapt  almost  anything  to  the  purpose 
until  a  better  dressing  can  be  procured. 


MANUAL   OF  BANDAGING.  25 

All  bandages  are  divisible  into  two  great  classes,  the  simple  and 
the  cotnpound.  Under  each  of  these  are  found  many  varieties,  the 
prominent  ones  of  which  will  be  given  under  their  respective  heads. 

A  Simple  Bandage  is  understood  to  be  of  a  single  strip  of 
flannel,  or  cotton,  and  may  have  one  or  two  heads ;  may  or  may  not 
be  invaginated.  In  Mayor's  system,  a  single  triangle  or  quadri- 
lateral, invaginated  or  not,  comes  under  this  division. 

A  Compound  Bandage  can  be  briefly  defined  as  a  bandage 
made  up  of  two  or  more  pieces  of  flannel  or  cotton,  whether  in 
strips  (rollers),  triangles,  cravats,  or  quadrilaterals ;  and  may  be  in- 
vaginated, stitched  (as  a  X))  or  modified  in  any  way  that  the  surgeon 
may  see  fit. 

Besides  these  two  general  classes  we  have  a  regional  classifica- 
tion ;  merely,  however,  for  descriptive  convenience,  as  the  execution 
of  a  bandage  is  essentially  the  same  in  all  parts  of  the  body.  These 
divisions  are  ist.  Bandages  of  the  Head.  2d.  Bandages  of  the  Neck. 
3d.  Bandages  of  the  Upper  Extremity.  4th.  Bandages  of  the  Trunk. 
5  th.  Bandages  of  the  Lower  Extremity. 

This  general  plan  of  description  we  shall  follow,  giving  first  the 
roller  bandages  belonging  to  the  simple  order,  following  each  one 
with  Mayor's  that  fulfill  the  same  office  ;  and  lastly  give  those  of  the 
compound  order,  Mayor's  triangles  and  cravats  following  those  of 
Gerd/s  system  (the  roller  bandages),  as  before. 


26 


BANDAGES  OF  THE  HEAD. 


CHAPTER    V. 

BANDAGES    OF    THE    HEAD. 

SKULL-CAP. 

In  all  of  the  bandages  of  the  head  it  is  well  to  first  apply  a  close- 
fitting  flannel  or  cotton  cap,  known  as  a  skull-cap,  to  the  head.  It 
retains  the  bandage  better  in  position,  as  it  keeps  the  turns  from 
coming  in  contact  with  the  slippery  and  sliding  hair.  It  will  also  be 
found  full  as  comfortable  to  the  patient,  as  it  tends  to  keep  the 
hair  evenly  distributed  about  the  head,  and  so  prevents  its  matting 
under  different  portions  of  the  bandage.  Pressure  from  the  band- 
age is  also  more  equable. 


CIKCULAE  OF  THE  FOKEHEAD  AND  EYES. 

Description. — It  should  be  three  or  four  yards  in  length  and 
have  a  width  of  from  one  and  one-half  to  two  inches. 

Application. — Place   the  initial  end  i  at  or  near  the  centre  of 
FIG.  12.  the  forehead,  standing  at  the  back  of 

the  patient,  and  confine  by  a  horizontal 
circular  turn,  2.  At  the  3d  turn  begin  to 
drop  the  course  of  the  bandage  still 
more,  so  that  on  its  completion  it  shall 
have  been  dropped  one-half  or  three- 
quarters  of  its  width.  The  4th  turn  is 
to  be  made  in  a  similar  manner,  cover- 
Circuiar  of  the  Forehead  and  Eyes  ing  the  eyes  and  as  much  of  the  face 
as  seems  necessary ;  then,  after  an  upward  spiral  course,  5,  confine 
the  bandage  by  a  pin  or  thread,  at  or  near  its  starting  point. 

Uses.— This  bandage,  though  necessarily  so  simple,  fulfills 
many  important  indications.  In  wounds  of  the  forehead  or  upper 
part  of  the  face,  and  operations  thereon,  in  injuries  and  operations 


MANUAL   OF  BANDAGING.  27 

of  the  eyes  and  nose,  and  nasal  passages,  it  serves  to  convey  proper 
soothing  applications  to  the  parts,  as  well  as  to  restrain  excessive 
muscular  action,  and  so  facilitates  union  between  the  edges  of  the 
wound. 


THE  FILLET  OR  HEAD-BAND. 

Description. — A  piece  of  flannel,  or  cotton,  thirty  inches  long 
by  twelve  inches  wide.  At  a  half  an  inch  from  the  inferior  border, 
midway  from  the  two  ends  of  the  bandage,  cut  out  a  triangular  piece 
(the  base  downwards)  so  as  to  leave  an  opening  sufficiently  large  to 
admit  the  nose. 

Application. — Standing  behind  your  patient,  place  the  centre 
FIG.  13.  of  the  bandage  over  the  face,  covering 

it  from  the  mouth  up ;  the  nose  being 
permitted  to  pass  through  the  triangu- 
lar opening.  Carry  each  end  horizon- 
tally backwards  about  the  head,  and 
confine  with  pins  or  stitches. 

Uses. — This  bandage  admirably 
takes  the  place  of  the  preceding  in 
retaining  dressings  to  the  parts  about 
the  upper  portion  of  the  face.  It  can 
be  used  (though  it  is  less  elegant)  in 
the  place  of  the  Monocle  or  Binocle, 

The  Fillet  or  Head-band.  SOOn    tO  be  treated  of 

A  '' S/ing''  and  a  "  Triangle"  of  the  face  have  been  devised,  but 
are  really  not  so  convenient  as  the  Fillet.  The  former  is  a  four-tailed 
bandage  (made  similarly  as  the  Sling  Compress,  Fig.  4,  page  17). 
The  body  of  the  bandage  is  placed  over  the  face,  and  the  extremities 
are  carried  backwards  and  fastened,  the  two  superior  at  the  nape  of 
the  neck  ;  the  two  inferior  above  the  occiput ;  or,  they  may  be  crossed 
at  these  points  and  brought  forward,  and  finally  confined  in  front. 
The  Facial  Triangle  is  applied  in  a  similar  manner.  It  should  be,  the 
base  of  the  triangle,  one  yard  in  length ;  the  height,  that  is  from  the 
base  to  the  apex,  should  be  eighteen  inches. 


28 


BANDAGES  OF  THE  HEAD. 


CROSS  OF  THE  EYE. 


{Monocle.) 

Description. — This  bandage  should  be  six  yards  in  length  and 
have  a  width  of  from  one  and  a  half  to  two  inches. 

Application. — Taking  the  right  eye,  for  example,  standing  be- 
FiG.  14.  hind  your  patient,  place  the  initial  end 

ol  the  roller,  i,  above  the  right  eye> 
previously  protected  by  a  compress  or 
some  cotton-wool.  Confine  this  by  one 
horizontal  circular  turn,  2,  about  the 
head  and  continue  on  till  you  come  to 
the  occiput,  for  the  next  turn ;  here 
you  make  a  pass  downwards,  coming 
along  under  the  right  ear,  then  up  over 
the  inferior  angle  of  the  inferior  maxilla 
of  the  right  side,  and  across  the  inner 
angle  of  the  orbit,  finishing  the  third 
Cross  of  the  Eye.  coursc  of  the  bandage.    Continuing  on 

from  this  point  (the  forehead),  the  bandage  is  to  be  carried  up  over 
the  left  parietal  protuberance,  then  down  to  a  level  with  the  circular 
turns  I  and  2,  and  finally  finished  as  a  circular  of  the  head,  thus 
making  the  fourth  course.  Course  5  is  to  be  executed  the  same  as 
course  3,  remembering  to  overlap  in  its  course,  to  the  distance  of 
one-half  or  three-quarters  of  its  width,  the  preceding  turn.  Course 
6  is  executed  the  same  as  course  4,  remembering  the  overlapping. 
Finally,  when  you  come  near  the  terminal  end  of  your  bandage,  con- 
fine by  one  or  two  circular  turns  about  the  forehead  and  occiput, 
following  courses  i  and  2. 

Uses. This  is  a  very  pretty  and  firm  monocular  bandage  when 

evenly  applied ;    yet  it  is  one  that  needs  some  watching  lest  some  of 
the  courses  overshp  each  other,  especially  if  put  on  a  patient  that  is 
not  very  quiet.     A  light  compress  or  cotton-wool  should  fill  up  the 


MANUAL  OF  BANDAGING. 


29 


orbital  cavity,  thus  not  only  keeping  the  lids  securely  closed,  but  it 
will  steady  the  eye-ball  in  its  socket,  as  well  as  produce  slight  com- 
pression. 

In  the  case  of  the  left  eye,  the  proceeding  is  the  same,  reversing 
only  the  direction  of  the  courses. 

For  7%(?  Triangle  of  the  Eye,  see  "  Uses  "  under  the  bandage 
Fronto-oculo-occipital  Triangle,  page  30. 


CROSS   OF   THE  EYES. 

(Binocle.) 

Description. — This  bandage  should  be  eight  yards  in  length 
and  have  a  width  of  from  one  and  a  half  to  two  inches. 

Application.^ — Standing  behind  your  patient,  place  the  initial 
FIG.  15.  end  of  the  bandage,    i,  over  his  right 

eyebrow,  and  confine  there  by  a  hori- 
zontal circular  turn  about  the  head,  2. 
On  the  third  turn,  when  coming  to  the 
occiput,  pass  the  bandage  down  so  as  to 
come  around  under  the  right  ear,  up  over 
the  inferior  angle  of  the  lower  maxilla, 
and  up  over  the  inner  angle  of  the  orbit 
of  the  right  side,  thus  finishing  the  third 
course  of  the  bandage.  From  this  point 
carry  the  bandage  up  over  the  left  parie- 
Cross  of  the  Eyes.  tal  eminence,  then  down  to  the  occiput, 

and  finally  horizontally  about  the  head,  thus  finishing  course  4. 
Continue  the  course  of  the  bandage  horizontally  about  the  head  un- 
til you  come  to  the  occipital  region,  when  you  mount  up  over  the 
right  parietal  eminence,  and  pass  downwards  over  the  inner  canthus 
of  the  left  eye,  thus  finishing  the  fifth  course  of  the  bandage.  Con- 
tinue the  bandage  down  across  the  left  cheek  and  maxilla,  and  back 
under  the  left  ear  to  the  occiput,  where  you  mount  up  to  the  level  of 
courses  i  and  2,  when  you  finish  course  6  as  a  horizontal  turn  about 
the  head. 


30  BANDAGES    OF   THE   HEAD. 

Turns  7,  8  and  9  are  done  the  same  as  Nos.  3,  4  and  5, 
respectively,  remembering  always  to  draw  in  the  bandage,  by  over- 
lapping its  underlying  fellow  by  one-fourth,  or  one-third  its  AAidth. 

On  the  completion  of  its  application  to  the  eyes,  confine  by  a 
single  horizontal  turn  about  the  forehead  and  occiput,  fastening  with 
a  pin. 

Uses. — This  bandage  fulfils  the  same  indications  for  both  eyes 
that  the  preceding  does  for  the  one  eye.  The  "  double-headed " 
roller,  for  the  same  purpose,  I  have  omitted,  as  it  is  not  so  firm  a 
bandage,  and  is  more  complicated.  The  ears  and  parietal  protu- 
berances are  the  main  points  of  support  to  these  ocular  bandages  ; 
hence  pay  particular  attention  to  the  "laying  of  the  bandage"  about 
these  parts. 


FKONTO-OCULO-OCCIPITAL    TKIANGLE. 

(Head-band  of  Mayor's  System.) 

Description. — Take  a  piece  of  cotton-cloth  large  enough  so 
that  when  folded  to  a  triangle,  the  base  of  the  triangle  will  measure 
one  yard,  while  its  height  (from  apex  to  centre  of  base)  will  be  from 
fifteen  to  twenty  inches. 

Application. — Standing  behind  the  patient,  place  the  base  of 
FIG.  16.  the  triangle  over  the  eyes,  having  the  apex 

over  the  head,  pointing  to  the  occiput. 
Carry  both  ends  of  the  base  horizontally 
around  to  the  occiput,  covering  over  the 
apex  of  the  bandage,  and  cross  there, 
bring  them  forwards  and  confine  at  the 
forehead,  a,  a,  either  by  pinning  or 
tying.  Lastly,  carry  the  apex  from  the 
occiput  up  over  the  horizontal  courses  of 

the  two   extremities  to   the  region  of  the 

Fronto-Oculo-Occipital  Triangle     r       v      j         j  r  -^i 

forehead,  and  confine  with  a  pin,  as  at  b. 

Uses. — This  is  a  very  simple  bandage,  as  indeed  all  of  Mayor's 
are,  and  will  nicely  take  the  place  of  the  preceding  Cross  of  the 


MANUAL    OF  BANDAGING,  81 

Eyes,  or  Binocle.  It  can  be  easily  tilted  to  one  side,  covering  in 
only  one  eye,  so  as  to  fulfil  the  condition  of  the  monocular  cross, 
plated  on  page  28.  It  is  not  so  firm,  or  evenly  compressing  a 
bandage,  as  the  two  preceding,  and  hence  would  not  be  so  appli- 
cable after  an  operation  for  cataract,  or  an  iridectomy.  Of  course 
cotton-wool,  or  some  light  dressing,  will  need  to  be  applied  to  the 
ocular  fossae  before  the  application  of  this  triangle,  just  as  in  the 
Crosses  of  the  eyes. 


FRONTO-OCCIPITAL    TEIANGLE. 

(Triangular  Bonnet  of  the  Head.) 

Description. — This  bandage  should  measure  one  yard  or  more 
from  end  to  end,  across  the  base,  and  should  have  a  height  of  fifteen 
or  twenty  inches. 

Application. — Standing  behind  the  patient,  place  the  base  of 
I'lG-  17.  the   triangle,    i,  at  the  forehead,  over 

the  eyes,  having  the  apex  at  the  occiput. 
Carry  the  two  extremities  horizontally 
backwards  to  the  occiput,  covering  in 
the  apex,  cross  them  there,  and  then 
bring  them  forwards  and  confine  at  the 
forehead,  2.  Finally  bring  the  apex 
forwards  and  confine,  as  at  b. 

Fronto-occipitai  Triangle.  Modifications.— I.    By  reversing 

the  application  of  this  bandage,  putting  the  base  at  the  occiput  and 
the  apex  at  the  forehead,  you  get  the  Occipito-frontal  Triangle  of 
Mayor. 

II.  By  placing  the  base  at  one  of  the  sides  of  the  head,  the  apex 
covering  the  other,  you  get  Mayor's  Biparietal  Triangle. 

Uses. — The  uses  of  these  triangles  are  very  numerous,  as  they 
are  applicable  for  maintaining  any  dressing  to  almost  any  p  art  ofthe 
head.  In  so  doing  they  take  the  place,  in  great  measure,  of  the 
Recurrent  of  the  Head,  and  the  Six-Tailed  Bandage  of  the  Head 
to  be  described  further  on. 


32 


BANDAGES    OF   THE  MEAD 


FIG.    IS. 


SIMPLE    CROSS    OF    THE    CHIN. 

(Roller  Bandage  of  the  Chin.) 

Description. — ^This  bandage  should  be  about  nine  yards  in 
length,  and  have  a  width  of  one  and  one-half  inches. 

Application. — Standing  at  your  patient's  back,  place  the  initial 

end  of  the  bandage,  i,  over  the 
left  eyebrow,  and  confine  by  one 
single,  horizontal,  circular  turn,  2, 
bringing  the  bandage  down  under 
the  right  ear,  continuing  it  under 
the  lower  maxilla  and  up  over  the 
left  maxillary  ramus,  and  ear,  fin- 
ishing turn  3.  Make,  for  turns  4 
and  5,  two  vertical  circular  passes 
in  the  course  of  turn  3,  gradually 
working  towards  the  symphysis  of 
the  lower  jaw,  by  overlapping  each 
preceding  turn  one-half  or  one- 
After  turn  5  has  been  brought  to 
the  right  inferior  angle  of  the  lower  jaw,  make  a  single  horizontal 
circle  of  the  neck,  6.  At  the  back  part  of  the  neck  mount  up  the 
occiput,  so  as  to  make  the  fron to-occipital  horizontal  turn  7.  Then 
continue  on  to  the  occiput,  down  below  the  right  ear,  across  the 
symphysis  of  the  chin,  making  turn  8.  Circle  the  chin  again,  hori- 
zontally (turn  9),  then  mount  to  the  top  of  the  head,  passing  under 
the  lower  jaw,  forming  turn  10,  which  is  still  anterior  to  turn  5.  Turn 
II  is  made  in  the  course  of  turn  10,  overlapping  it  in  its  course. 
Bring  the  bandage  down  under  the  lower  jaw  again,  thence  circle  the 
neck  horizontally,  forming  turn  12.  Finally,  mount  to  the  forehead 
from  the  occipital  region,  and  confine  your  bandage  by  a  horizontal 
circular  turn,  as  13. 

Uses. — In  cases  of  fractures  or  dislocation  of  the  lower  jaw.  It 
is  also  of  use  in  confining  any  topical  application  to  the  chin,  to  the 
parotid  regions,  and  to  the  ears. 


^jiiiipie  C'rosa  of  the  CMn. 

fourth  the  width  of  the  bandage. 


MANUAL   OF  BANDAGING.  33 

Care  should  be  had  that  too  much  constriction  is  not  put  upon 
the  neck  in  making  turns  6  and  12,  thereby  hindering  respiration 
and  circulation.  If  a  flannel  roller  is  used  no  allowance  need  be 
made  for  the  swelling  of  the  parts,  as  the  bandage  will  generally  give 
enough,  if  it  is  only  "comfortably"  (to  the  patient)  applied  at  first. 


FOUR-TAILED    BANDAGE   OF   THE    CHIN. 

(S/ing  of  the  Chin.) 
Description. — This  bandage  should  be  one  and  one-fourth  yards 
FIG.  19.  in  length,  and  have  a  width  of  about  five 

inches.  It  should  be  torn,  at  the  middle 
of  each  end,  towards  the  centre  (as  you 
see  in  Fig.  4,  page  17)  to  within  two  and 
one-half  inches  of  this  point. 

Application.— Standing  at  the  back 
of  your  patient,  place  the  centre  of  the 
plane  of  the  bandage,  i,  at  the  chin ;  then 
carry  the  two  superior  ends  of  your  band- 
age backwards,  below  the  ears,  to  the 
nape  of  the  neck ;  crossing  them  here, 
Sling  of  the  Chin.  bring  them  upwards  and  forwards  over 

the  parietal  protuberances,  and  confine  at  the  forehead,  2.  Take 
now  the  two  inferior  ends  of  the  bandage,  carry  them  backwards 
and  obliquely  upwards  across  the  temporo-maxillary  articulations, 
and  confine  at  the  superior  posterior  angles  of  the  parietal  bones,  3. 
Uses. — This  is  quite  a  firm  and  solid  bandage,  and  very  easy  of 
application.  It  does  not,  however,  give  that  full  support  to  the  parts 
as  the  preceding,  yet  it  is  very  applicable  when  the  mobility  of  the 
parts  is  not  over-increased  by  a  very  oblique  or  double  fracture,  or 
by  extensive  luxations  of  the  inferior  maxilla.  For  the  maintaining 
of  dressings  to  the  chin,  parotid  region,  and  the  ear,  it  is,  from  its 
simplicity,  much  to  be  preferred  to  the  Simple  Cross  of  the  Chin. 


34 


BANDAGES   OF  THE  UEAD. 


OCCIPITO-MENTAL   TRIANGLE. 

(Mayor's  Triangle  of  the  Chi?i.) 

Description. — ^Have  your  triangle  with  a  base  full  one  and 
one-half  yards  in  length,  and  with  a  height  of  twenty  inches,  or 
more. 

Application. — Standing  behind  your  patient,  place  the  base  of 
FIG-  20.  the  triangle,    a,    the   apex   looking 

backwards,  at  the  top  of  the  head ; 
seize  the  two  ends  of  the  triangle 
and  bring  one  down  below,  and  the 
other  over  and  in  front  of  the  chin, 
crossing  them  this  way,  B,  b,  and 
then  carry  them  obliquely  backwards 
and  upwards  across  the  temporal 
and  mastoid  regions  to  confine  them 
at  the  summit  of  the  occiput.  Con- 
fine the  apex  as  at  d. 

Occipito-Mentai  Triangle.  Uscs. — This  bandage  was  de- 

signed by  Mayor  to  take   the  place  of  the  two  preceding  bandages 
this  it  does,  in  a  measure,  in  its  ready  applicability  for  the  confine- 
ment of  dressings  about  the  regions  it  covers.     It  is  easily  extem- 
porized, and  hence  is  a  "popular"  way  for  maintaining  topical  ap- 
plications to  these  parts. 

All  of  the  more  modern  appliances  for  the  treatment  of  fractures 
of  the  inferior  maxilla  are  but  modifications  of  the  three  bandages 
just  given.  A  paste-board,  or  felt  splint,  with  these  bandages, 
will  probably  fulfil  any  of  the  indications  that  these  more 
elaborate  appliances  are  designed  to,  and  are  full  as  comfortable  to 
your  patient. 


CROSS    OF    THE    HEAD, 
(Temple  Bandage.) 

Description. — This  bandage  should  be  two  inches  in  width  by 
six  or  seven  yards  in  length. 


MANUAL    OF  BANBAOINO. 


35 


Application. — Standing  behind  your  patient,  place  the  initial 
^i^«  21.  end  of  the  bandage,  i,  over  the  right 

eye,  and  confine  it  by  a  circular  turn, 
2,  about  the  head.  Continue  on  for  a 
third  course  until  you  come  to  the 
right  ear;  here  confine  the  bandage 
either  by  stitches,  or  a  pin,  inserted 
perpendicularly  to  the  preceding  cour- 
ses of  the  bandage.  This  done,  de- 
scend perpendicularly  with  the  roller- 
head  to  the  posterior  angle  of  the 
inferior  maxilla,  covering  over  the  right 
ear,  and,  passing  under  the  lower  jaw, 
continue  the  bandage  up  over  the  left 
Cross  of  the  Head.  g^r   to  the  top  of  the  head ;   then  de- 

scend to  the  horizontal  courses  of  the  bandage,  thus  completing 
course  4.  Turns  5,  6,  7  and  8  are  to  follow  in  the  course  of  turn 
4,  viz.,  perpendicularly  around  the  head,  remembering  to  bring  the 
bandage  gradually  forwards  by  overlapping  each  preceding  turn  the 
quarter,  or  half,  the  width  of  the  bandage.  Turn  8  being  brought 
to  the  level  of  the  horizontal  turn  2,  upon  the  right  side,  it  is  to  be 
fastened  with  stitches,  or  a  pin,  perpendicularly  to  the  course  of 
turns  6,  7  and  8,  the  remaining  bandage  being  exhausted  by  hori- 
zontal turns  about  the  head  and  occiput,  in  the  course  of  turns 
I  and  2. 

In  this  application  of  The  Cross  of  the  Head,  it  has  been 
supposed  that  it  was  the  right  ear,  temple,  or  parotid  region  that  was 
diseased,  or  injured.  In  case  of  the  left,  you  have  but  to  reverse 
the  application  of  the  bandage ;  that  is,  make  your  turns  from  left 
to  right,  across  the  forehead,  putting  the  initial  end  over  the  left  eye. 

Uses. — For  protection  of,  or  application  of  dressings  to,  the 
ears,  temples,  parotid  or  hyoid  regions.  Is  readily  applied  and 
makes  a  firm  dressing. 


36 


BANDAGES    OF   THE   HEAD. 


KNOTTED    BANDAGE    OF    THE    HEAD. 

Description. — This  bandage  should  be  one  and  a  half  inches 
in  width  and  eight  or  ten  yards  in  length,  and  rolled  into  two  heads. 

Application. — Place  the  plane  of  the  bandage  over  the  injured 
FIG.  22.  temple  (the  left,  for  example)  and  then 

carry  the  two  heads  horizontally  about 
the  head  to  the  right  parietal  region, 
where  you  cross  one  over  the  other ; 
continue  them  on  till  you  come  to  the 
starting  point,  thus  finishing  course  2. 
Crossing  them  here  at  right  angles 
(that  is,  upon  the  diseased  temple), 
carry  one  head  of  the  bandage  perpen- 
dicularly over  the  head,  while  you  carry 
the   other  perpendicularly  downwards 

Knotted  Bandage  of  the  Head.  j         ^i,         i,-  ^-       •  ^1 

^  under   the  chm,  3,  3,  contmumg   the 

course  of  each  around  the  head  and  chin,  until  they  meet  at  the 
diseased  temple  again,  thus  finishing  the  third  course.  Cross  them 
at  right  angles  again  at  this  point,  continuing  horizontally  about  the 
head,  as  in  course  i,  until  you  come  to  the  diseased  temple  again, 
thus  finishing  turn  4.  Turn  5  is  formed  the  same  as  was  turn  3,  and 
turn  6,  as  turn  4,  etc.,  etc. ;  at  last  confine  the  ends  of  the  bandage 
in  the  ordinary  way. 

Uses. — This  bandage  is  intended  to  exercise  pressure  upon 
the  temporal  artery,  as  in  case  of  wounds,  accidental  or  otherwise. 
It  needs  to  be  applied  with  care,  and  to  be  watched,  as  it  is  possible 
to  make  the  compression  too  severe  for  a  long-continued  application 
of  the  bandage.  It  should  always  be  aided  by  a  Graduated  Pyrami- 
dal Compress  (see  page  16). 


THE    T    OF    THE    HEAD    AND    EAE. 

(T  of  the  Temple.) 

Description. — Take  first  a  bandage  from  two  to  four  inches  wide 
(according  to  the  extent  of  the  injury  to  the  side  of  the  head)  and 
one  yard  in  length ;  at  right  angles  to  this  bandage,  at  a  distance  of 


MANUAL    OF  BANDAGING. 


37 


ten  or  twelve  inches  from  one  end,  there  should  be  stitched  another 
bandage  two  inches  wide  and  two  and  a  half  yards  in  length,  leaving 
one  of  its  ends  projecting  some  sixteen  or  eighteen  inches  beyond 
the  first  or  widest  portion. 

Application. — Place  the  point  of  juncture  of  the  two  bandages, 
FIG.  23.  A,   over  the  right  temporal  re- 

gion, if  this  be  the  one  involved, 
in  such  a  manner  that  the  widest 
portion  of  the  bandage,  B,  shall 
be  perpendicular,  as  regards  the 
head ;  then  carry  the  long  end 
of  this  wide  portion  of  the  band- 
age, B,  down  under  the  chin, 
and  up  on  the  other  side  to  the 
top  of  the  head,  there  tying  or 
pinning  it  to  the  short  end, 
brought  perpendicularly  up- 
wards from  the  diseased  tem- 

The  T  of  the  Head  and  Ear.  ,  •  n-T.     ■,  j 

poral  region.  The  longer  and 
narrower  portion  of  the  bandage,  a,  is  now  to  be  carried  horizon, 
tally  about  the  head,  the  long  end  confining  the  short  one  by  suc- 
cessive horizontal  courses  till  it  is  exhausted,  when  confine  in  the 
usual  manner. 

Uses. — For  confining  dressings  to  the  temporal,  parotid  and 
hyoid  regions. 


PEEFORATED  T  OF  THE  HEAD  AND  EAR. 

Description. — The  first  piece  should  be  three  yards  long  by  two 
inches  wide,  and  to  this,  perpendicular  to  its  plane,  there  should  be 
stitched,  at  eighteen  inches  from  one  of  its  ends,  a  bandage  having 
the  same  length  and  width,  save  at  the  extremity  attached  to  the 
first  piece ;  here  it  should  be  semi-oval,  with  a  width  two  or  three 
times  that  of  the  plane  of  the  bandage ;  this  oval  part  should  be  per- 
forated by  a  longitudinal  slit  of  sufficient  size  to  "  take  in  "  the  ear. 

Application. — Pass  the  ear  of  the  diseased  side  (suppose  it  to 
be  the  right)  through  the  second  portion  of  the  bandage,  b,  bringing 


38 


BANDAGES    OF   TEE   HEAD. 


FIG.  24,  the  bandage  closely  and  snug- 

ly up  to  the  head.  Carry  the 
shorter  end  of  the  horizontal 
portion  of  the  bandage  smooth- 
ly around  the  occiput  and 
forehead,  and  confine  by  a 
single  horizontal  circular  turn, 
2.  Carry,  now,  the  perpen- 
dicular portion  of  the  band- 
age, B,  down  under  the  chin, 
up  over  the  opposite  ear  to 
the  top  of  the  head,  and  down 
to  the  starting  point,  thus 
finishing  the  first  turn  of  the 
perpendicular  portion  of  the  bandage.  Exhaust  the  remaining 
portion  of  the  bandage,  b',  by  similar  perpendicular  turns  about  the 
head,  and  at  last  confine  the  end,  by  a  pin,  to  the  horizontal  turn 
2.  This  done,  exhaust  the  remaining  portion  of  the  roller,  a,  by 
horizontal  turns  about  the  head,  confining  as  usual. 

Uses. — This  bandage  is  found  very  useful  in  maintaining  blis- 
ters to  the  mastoid  process,  or  dressings  thereto,  as  is  frequently 
needed  in  diseases  of  the  ears.  It  is  equally  useful  in  confining 
dressings  upon  the  ears,  temporal,  parotid,  and  tonsillar  regions. 


Perforated  T  of  the  Head  and  Ear. 


OCCIPITO-AURICULAE    TRIANGLE. 

(Jlfayor's  Cross  of  the  Head.) 

Description. — This  should  be  a  triangle  having  a  base  of  one 
yard  in  length,  and  a  height  of  some  eighteen  inches. 

Application. — This  is  essentially  the  same  as  that  of  the  Occi-. 
pito-mental  Triangle  (page  34).  The  only  difference  being  that  this 
one  is  crossed  below,  instead  of  upon,  the  chin. 

Uses. — Essentially  the  same  as  many  of  those  for  which  The 
Knotted  Bandage  of  the  Head  (page  2i^),  The  T  of  the  Head  and 
Ear  (page  37),  and  The  Perforated  X  o^  the  Head  and  Ear  (page 
38)  are  employed. 


MANUAL    OF  BANDAOINO. 


39 


Recurrent  Bandage  of  the  Head. 


RECUEEENT  BANDAGE  OF  THE  HEAD. 

(Roller  Cap  of  the  Head.) 

Description. — This  should  be  one  and  one-half  or  two  inches 
in  width,  and  about  nine  yards  in  length.  It  should  be  rolled  into 
two  heads,  one  being  a  little  larger  than  the  other. 

Application. — Standing  at  the  back  of  your  patient,  place  the 
FIG.  25.  plane  of  the  bandage  above 

the  eyebrows,  carrying  each 
roller  head  backwards  above 
the  ears  to  the  occiput ;  cros- 
sing them  there  at  right  angles, 
carry  the  inferior  portion  up 
over  the  top  of  the  head,  in 
line  of  the  saggital  suture,  2, 
to  the  forehead ;  this  is  called 
the  "recurrent"  portion.  Now 
carry  horizontally  forwards  the 
other  roller-head,  crossing  over  the  recurrent  portion  (thus  binding  it 
down)  at  the  left  frontal  region,  thus  finishing  the  horizontal  turn  2' . 
Carry  now  the  recurrent  roller-head  up  over  the  horizontal  turn  2' 
and  the  right  parietal  eminence  down  to  the  occiput,  thus  finishing 
the  turn  3.  Conduct  the  other  roller-head  again  horizontally  about 
the  head,  binding  down  the  course  3  at  the  occiput,  and  finish  it  as 
turn  3'  at  the  forehead.  Courses  4,  6,  8  and  10  are  made  similar  to 
course  2,  whilst  courses  5,  7  and  9  are  formed  similarly  as  course  3. 
The  horizontal  courses  4',  5',  '6  and  7'  are  formed  similarly  as  their 
preceding  courses,  2'  and  3',  each  binding  down  some  one  course  of 
the  recurrent  portions  of  the  bandage, — -the  turns  4,  5,  6,  7,  8,  9  and 
10,  running  from  the  forehead  to  the  occiput. 

Uses. — -This  is  not  a  very  useful  bandage,  though  it  looks  very 
nicely  when  properly  applied.  The  objection  to  it  is,  that  to  give  it 
the  proper  degree  of  firmness  and  security,  one  has  to  draw  the  con- 
fining turns  of  the  bandage  quite  tightly  ;  and  this,  from  the  repeti- 
tion of  these  turns  so  directly  above  the  others,  gives  to  the  patient 
an  uncomfortable  feeling  of  tightness   and  constriction  about  the 


40 


BANDAGES    OF   THE   HEAD. 


head.  Besides  this,  if  the  wound  is  very  large,  it  will  press  upon  the 
bruised  portions,  and  so  cause  excessive  pain,  and  venous  obstruc- 
tion. In  scalp  wounds  of  the  top  of  the  head  it  might  be  used  to 
good  advantage. 


FIG.   26. 


SIX-TAILED   BANDAGE   OF   THE  HEAD. 

(Sling  of  the  Head.) 

Description. — This  bandage  should  be  forty  inches  in  length, 
by  fifteen  in  width.  Double  it,  lengthwise,  at  the  middle ;  then,  at  a 
point  {upon  each  side)  three  inches  from  the  lateral  border,  i,  cut 
directly  toward  the  folded  centre  till  you  come 
to  within  three  or  four  inches  of  it,  2.  Then 
cut  obliquely  toward  the  same  point,  repre- 
sented by  the  line  3-2  in  the  cut,  thus  remov- 
ing the  triangular  pieces  1-2-3  ^^^  3-2-1. 
The  portion  2)~2)  should  be  three  inches  in 
width. 

Application. — Place  the  plane  of  the 
bandage  upon  the  top  of  the  head,  the  ends 
Bring  the  central   ends,  a,  a',  directly  down 


Diagram. 


being  at  the  sides. 


FIG.  27. 


Six-tailed  Bandage  of  the  Head. 


under  the  chin,  and  there 
confine  by  tying.  Carry  then 
the  two  front  ends,  b,  b', 
horizontally  backwards,  and 
confine  at  the  occiput.  This 
done,  bring  the  two  posterior 
ends,  c,  'c,  horizontally  for- 
wards, and  confine  at  the 
forehead. 

Uses. — This  bandage  is 
applicable  for  dressing  any 
injury  of  the  top  or  sides  of 
the  head.  As  it  is  simple, 
easily   applied,    and  readily 


MANUAL   OF  BANDAGING.  41 

maintains  its  position,  it  may  be  preferred  to  the  preceding  and 
following.  The  suggestion  that  Galen  makes  (for  it  is  known  as  his 
bandage)  is  a  good  one.  It  is  to  split  the  two  middle  ends,  so  as  to 
allow  the  passage  of  the  ears  in  cases  where  the  condition  of  the 
patient  will  warrant  such  exposure. 


TRIANGLE    OF    THE    HEAD. 

(Handkerchief  Bandage.) 

Description. — This  bandage  should  be  a  piece  of  linen,  or  a 
handkerchief,  twenty-four  to  thirty  inches  square.  Fold  it  to  a 
triangle. 

Application. — Standing  behind  your  patient,  place  the  bandage 
FIG-  28.  over  the  top  of  the  head,  the  triangu- 

lar portion  hanging  down  over  the 
face.  Carry  the  two  ends  a,  a'  for- 
wards to  the  forehead,  there  crossing 
them  so  as  to  carry  them  back,  2,  2, 
to  the  occiput,  to  be  confined  by 
tying  or  pinning.  Then  seize  the 
triangular  portion  that  hangs  in  front 
of  the  face,  and  carry  it  directly  up- 
wards and  fold  it  under  the  horizontal 
Triangle  of  the  Head.  turns  of  A,  a',  as  at  C. 

Uses. — As  it  is  easily  applied,  and  the  material  always  at  hand, 
it  makes  an  excellent  temporary  bandage  in  cases  of  wounds  or  in- 
juries of  the  upper  portion  of  the  head.  It  is  not,  however,  quite  so 
firm  a  dressing  as  the  bandage  just  described. 


DOUBLE  T  OF  THE  NOSE. 
Description. — A  strip  of  flannel,  two  and  one-half  yards  long 
by  one  inch  wide.  At  the  central  portion  of  this,  at  a  distance  of 
one  inch  from  each  other,  there  are  to  be  stitched,  at  right  angles 
with  the  first  piece,  two  other  strips,  each  thirty  inches  in  length  by 
three-quarters  of  an  inch  in  width. 


42 


BANDAGES    OF   THE   HEAD. 


Application. — Standing  behind  your  patient,  place  the  plane 
FIG.  29.  of  the  main   bandage   (rolled  into 

two  heads)  beneath  the  nose,  a,  and 
so  that  the  other  two  portions,  b', 
B,  may  pass  up,  one  upon  each 
side,  along  the  nose.  Carry  the 
heads  of  the  main  bandage,  a,  hori- 
zontally backwards  to  the  occiput, 
and  cross  one  head  above  the  other; 
then  take  the  two  perpendicular 
portions  of  the  bandage,  b',  b,  up 
over  the  top  of  the  head,  having 
them  cross  each  other  at  the  root  of 

Double  T  of  the  Nose.  ^i  ^i     ^   it,       •    Ui      "n 

the  nose,  so  that  the  right  will  pass 
over  the  left  parietal  region,  the  left  over  the  right  parietal  region, 
and  continue  their  courses  down  to  the  neck,  passing  one  of  them 
beneath  the  crossed  courses  of  the  main  part,  A ;  then  carry  the  two 
roller-heads  A  a',  obliquely  upwards  across  the  forehead,  and  confine 
with  pins,  etc.,  after  exhausting  both  by  horizontal  turns  about  the 
forehead  and  occiput.  This  done,  tie  the  ends  of  the  portions  b',  b, 
about  the  first  turn  of  the  roller-heads  of  the  portion  a,  at  the  nape 
of  the  neck. 

Uses. — To  maintain  dressings  to  the  parts  about  the  nose,  as  in 
cases  of  injury,  or  after  a  rhinoplastic  operation ;  or,  to  hold 
coapted  the  nasal  bones,  when  fractured. 


T  OF  THE  MOUTH. 
Description. — This  bandage  should  be,  the  main  piece,  two 
yards  long  and  two  inches  wide.  At  twenty-four  inches  from  the 
initial  end  of  this  piece  there  should  be  stitched  (at  right-angles)  to 
the  superior  border,  a  second  strip,  two  feet  in  length  by  two  inches 
in  width.  Cut  out  a  triangular  piece,  large  enough  for  the  passage  of 
the  nose,  from  this  second  bandage  at  the  place  where  it  is  joined , 
to  the  main  roller.  Also,  from  the  main  roller,  at  a  point  below  the 
triangular  opening  for  the  nose,  cut  out  a  sufficiently  large,  oval  sec- 
tion to  accommodate  the  mouth  and  lips. 


MANUAL  OF  BANDAGING.  43 

Application. — Standing  behind  your  patient,  place  the  plane 
FIG.  30.  of  the  bandage  across  the  face,  so  that 

the  oval  aperture  will  correspond  to 
the  mouth,  and  the  triangular  to  the 
nose ;  carry  the  two  ends  of  the  main 
bandage,  a,  a',  backwards  under  the 
ears  to  the  nape  of  the  neck,  and  cross 
them,  one  above  the  other,  there.  Then 
conduct  the  perpendicular  portion  of 
the  bandage,  b,  up  between  the  eyes, 
over  the  summit  of  the  head,  down  to 
the  crossed  ends  of  the  part  a,  a',  and 
T  of  the  Mouth.  either  confine  there  by  pins  or  stitches; 

or,  after  passing  under  and  then  over  the  crossed  courses  of  the 
main  bandage,  remount  the  head  and  confine  at  or  near  the  fore- 
head. This  done,  carry  the  ends  of  the  main  bandage  forwards  over 
the  ears  and  exhaust  them  by  horizontal  turns  about  the  forehead 
and  occiput,  as  at  a  2,  the  shorter  extremity  being  first  applied. 

Uses. — For  confining  dressings  about  the  mouth,  jaws,  cheeks, 
or  for  maintaining  the  parts  in  apposition  after  plasting  operations,  or 
other  surgical  procedures.  This,  and  the  preceding  bandage,  are 
especially  applicable  in  cases  of  transverse  wounds  of  the  lip  at  the 
nasal  alae,  or  fraenum. 


INVAGINATED  EOLLEE  OF  THE  UPPEE  LIP. 

(Hare-lip  Bandage.) 

Description. — I.  A  two-headed  roller,  three  yards  long  by 
three-quarters  of  an  inch  wide. 

II.  A  long  narrow  compress,  say  one  and  one-fourth  yards  in 
length  by  two  inches  in  width. 

III.  A  graduated  pyramidal  compress,  two  inches  in  length,  one 
and  one-half  inches  in  width,  and  one  inch  in  thickness.  The  folds 
of  the  compress  should  be  stitched  through  and  through,  at  each 
end,  in  order  to  prevent  their  slipping. 


44 


BANDAGES  OF  THE  HEAD. 


Application. — Place  the  graduated  compresses  a,  a',  one  upon 
FIG.  31.  each  side,  in  the  hollow  of  the  cheeks, 

below  the  zygoma,  and  at  about  one  inch 
distance  from  either  angle  of  the  mouth, 
pressing  the  cheeks  and  lips  well  forwards 
towards  the  median  line.  Delivering  them 
to  the  care  of  an  assistant,  take  the  long 
compress,  e,  and  place  its  middle  over  the 
summit  of  the  head,  allowing  the  ends  to 
hang  down  over  the  sides  of  the  face,  and 
to  cover  in  the  graduated  compresses,  the 
patient  finally  holding  the  ends  together 
under  the  chin.  This  done,  place  the 
invaginaiedRoUer  of  the  Upper  pl^ne  of  the  double-headed  roller,  I,  upon 
Lip.  the   forehead,  standing   behind   your  pa- 

tient, and  carry  the  heads  backwards  and  downwards  to  the  nape 
of  the  neck,  here  crossing  them  to  carry  them  horizontally  forwards 
to  the  superior  lip,  2,  2',  passing  one  through  a  slit  in  the  other. 
Then  carry  them  horizontally  backwards  to  the  neck,  crossing  them 
again  at  that  point,  to  carry  them  forwards  to  the  lip  again,  passing 
one  through  the  other,  as  before,  thus  finishing  turn  3,  3',  consigning 
the  heads  to  an  assistant.  Take,  now,  the  two  ends  of  the  long  com- 
press that  has  been  confined  temporarily,  by  the  patient,  and  fold 
each  upwards  over  the  circular  turns  of  the  roller,  and  confine  with 
pins  at  the  temple  or  top  of  the  head.  This  done,  take  the  roller- 
heads,  carry  them  horizontally  backwards  (over  the  folded  com- 
press) to  the  nape  of  the  neck,  recrossing  them  to  mount  up  to  the 
forehead,  and  exhaust  there  by  horizontal  circular  turns. 

Uses. — Useful  in  all  wounds  of  the  lips  for  keeping  the  parts 
eoapted ;  in  operations  for  cure  of  "  hare-lip  '"  where  the  tissue  seems 
to  be  scanty,  and  the  lip-wounds  are  hard  to  bring  together,  it  is 
especially  applicable. 

Variety. — This  bandage  can  be  made  equally  available  for 
wounds  of  the  lower  lip.  It  is  then  to  be  known  as  the  Livagitiated 
Roller  of  the  Under  Lip.  The  only  difference  in  the  application 
being  that  the  pyramidal  compresses,  a,  a',  shall  be  dropped  lower, 
and  that  the  crosses  of  the  bandage  2,  2',  and  3,  3',  shall  take  place 
upon  the  labium  inferius. 


MANUAL  OF  BANDAGING. 


45 


FEONTO-CEEVICO-LABIAL  TEIANGLE. 

(Mayor's  Invaginated  Bandage  of  the  Upper  Lip.) 

Description. — A  square  should  be  folded  to  a  triangle,  having 
a  base  of  forty  inches,  and  a  height  of  eighteen  inches. 

Application. — Place  the  centre  of  the  base  of  the  triangle  upon 
FIG.  32.  the  forehead,  a,  carrying  the  extremities 

down  and  backwards  to  the  nape  of  the 
neck,  covering  over  the  apex  of  the  tri- 
angle, there  crossing  them;  then  bring 
them  forward  over  the  upper  lip,  putting 
one  extremity  through  a  slit  in  the  other, 
as  2,  2'.  Carry  the  ends  horizontally  back- 
wards to  the  nape  of  the  neck,  there  con- 
fining them  by  tying,  or  otherwise.  The 
apex  of  the  triangle  is  to  be  carried  direct- 
ly up  over  the  occiput  and  pinned  at  the 
summit  of  the  head,  as  at  3.  Compresses 
similar  to  those  used  in  the  preceding  can  be  employed  to  advantage 
in  this  bandage  of  Mayor's  ;  and  they  are  especially  indicated  if 
much  tendency  to  gaping  exists  in  the  wound. 

Uses.^ — The  same  as  those  of  the  preceding.  As  it  is  more 
easily  applied,  and  quite  as  serviceable,  it  might  be  recommended, 
in  most  cases,  to  take  the  place  of  the  Roller  Invaginated  for  the 
Upper  Lip. 

Variety. — Instead  of  crossing  the  extremities  of  the  triangle 
upon  the  upper  lip,  they  can  be  made  to  cross  upon  the  under  one, 
and  thus  fulfil  the  indications  of  The  Roller  Invaginated  of  the 
Under  Lip,  described  upon  page  44.  It  is  then  known  as  The 
Invaginated  Triangle  of  the  Under  Lip. 


Fronto-Cervico-Labial   Triangle. 


POSTERIOR  CROSS  OF  THE  HEAD  AND  NECK. 
(Cross  of  the  Occiput.) 

Description. — This  bandage  should  be  five  yards  in  length, 
and  one  and  one-half  inches  in  width. 
7 


46 


BANDAGES    OF   THE   HEAD. 


Application. — Standing  at  your  patient's  back,  place  the  initial 
FIG.  33.  end  of  the  bandage  near  the  occiput,  as  at 

I,  and  confine  it  by  a  single  horizontal 
turn,  2  ;  afterwards  carry  it  round  to  the 
forehead,  in  the  course  of  turn  2,  till  you 
come  to  the  left  parietal  protuberance, 
when  you  carry  it  diagonally  down  to  the 
nape  of  the  neck,  finishing  course  3  ;  con- 
tinue onwards  around  the  neck,  making 
a  horizontal  circular  turn  about  it  for 
course  4.  For  course  5,  carry  the  roller- 
head  obliquely  up  across  the  occiput,  over 
the  right  ear,  then  obliquely  down  to  the 

Posterior  Cross  of  the  Head  and  nape  of  the  neck,   from  over  the  left  ear, 
thus  finishing  course  6.     Course  7  is  the 

same  as  course  5.     Course  8,  the  same  as  course  6,  and  so  on ;  at 

last  finish  by  horizontal  turns,  about  the  forehead  and  occiput,  and 

confine  with  pins  as  usual. 

Uses.^ — In  confining  rubefacients  and  vesicants  to  the  nape  of 

the  neck  ;   also,  for  retaining  dressings,  or  emollient  applications,  to 

bums  and  other  injuries  about  the  occipital  region. 


FOUR-TAILED  BANDAGE  OF  THE  HEAD  AND  NECK. 

(S/mg  of  the  Occiput. ) 

Description. — This  should  be  forty-eight  inches  in  length  by 
five  inches  in  width.  Fold  it  lengthwise  at  the  centre,  and  cut  back 
the  ends,  in  the  median  line,  to  within  three  or  four  inches  of  the 
fold. 

Application.^ — Place  the  plane  of  the  bandage  at  the  nape  of 
the  neck ;  carry  the  superior  ends  of  the  bandage  up  over  the  head 
and  confine  there  by  tying.  Then  carry  the  inferior  ends  horizontal- 
ly forwards  around  the  neck,  and  tie ;  or  else  cross  them,  and  return 
to  the  back  of  the  neck  with  them,  and  there  pin. 

Uses.^ — Similar  to  that  of  the  Posterior  Cross  of  the  Head  and 
Neck,  described  above. 


MANUAL    OF  BANDAGING.  47 


CHAPTER   VL 

BANDAGES  OF  THE  NECK. 

CIECULAR    OF    THE    NECK. 
(Spiral  of  the  Neck.) 

Description. — This  bandage  should  be  one  yard  in  length  and 
one  and  a  half  inches  in  width. 

Application. — Place  the  initial  end  of  the  bandage  at  one  side 
of  the  neck,  quite  low  down,  and  exhaust  it  by  circular  turns,  gradu- 
ally working  upwards  to  the  jaw,  so  as  to  give  a  spiral  form  to  the 
courses  of  the  bandage.     Confine  in  the  usual  way. 

Uses. — Is  useful  in  maintaining  dressings  to  the  back,  sides,  or 
front  of  the  neck.  Caution  should  be  observed  that  it  does  not  con- 
strict the  parts,  and  so  impede  circulation. 


CERVICAL   CRAVAT. 

Description. — A  triangle  folded  to  a  cravat  of  sufficient  length 
to  encircle  the  neck  twice. 

Application. — Place  the  middle  of  the  cravat  over  or  near  the 
seat  of  injury,  carry  the  ends  horizontally  backward,  cross  them  and 
bring  forwards  again,  and  confine  by  tying. 

Uses. — Similar  to  the  Circular  of  the  Neck  ;  as  it  is  much 
simpler,  probably  this  bandage  of  Mayor  will  be  more  often  used 
than  the  preceding. 


POSTERIOR  FIGURE  OF  8  OF  THE  HEAD  AND  THE  AXILLA. 

Description. — This  bandage  should   be   nine  yards   long  by 
one  and  three-quarter  inches  wide. 


BANDAGES    OF   THE  NECK. 


Posterior  Figure  of  8  of  the  Head  and  the 
Axillae. 


Application. — Standing  at  the  back  of  your  patient,  place  the 
^^®'  ^^"  initial   end  of  the  bandage  at 

the  occiput,  i,  and  confine  by 
a  horizontal  turn,  2,  about  the 
head.  Bend,  now,  the  patient's 
head  backwards  and  carry  the 
bandage  up  over  the  left  parie- 
tal protuberance,  then  down 
across  the  neck  to  the  right  ax- 
illa, thus  finishing  turn  3.  Then 
carry  the  roller-head  under  the 
arm,  up  over  the  front  of  the 
right  shoulder,  then  to  the  left 
parietal  protuberance,  in  line  of 
course  3,  thus  finishing  course 
4.  Continue  the  course  of  the 
bandage  about  the  forehead, 
mount  the  right  parietal  eminence,  and  descend  diagonally  down 
across  the  back  of  the  neck  to  the  left  axilla,  thus  finishing  course  5. 
Pass  the  bandage  under  this  arm,  up  over  the  front  of  this  shoulder, 
and  re-mount  to  the  right  side  of  the  head,  in  line  of  course  5,  thus 
finishing  turn  6.  Make,  then,  a  complete  horizontal  circuit  of  the 
head,  for  course  7,  coming  down  over  the  left  parietal  eminence  to 
the  right  axilla  for  turn  8.  Make  course  9  similar  to  course  4,  course 
10  to  course  5,  course  11  to  course  6,  slightly  overlapping  the  pre- 
ceding turn  in  each  case,  and  finally  exhaust  by  horizontal  turns 
about  the  forehead  and  occiput,  there  confining  as  usual. 

Uses. — In  cases  of  burns  of  the  anterior  surface  of  the  neck  and 
the  upper  part  of  the  chest,  where  vicious  contraction  of  the  cicatrix 
is  to  be  feared.  Also  in  horizontal  wounds  of  the  back  of  the  neck, 
thus  aiding  in  securing  the  proper  coaptation  of  the  parts.  This  is 
quite  a  firm  bandage,  and  most  any  degree  of  backward  flexion  of  the 
head  can  be  maintained. 

Note. — Turns  4,  6  and  9  have  been  exaggerated,  at  their  crossing 
upon  the  back  of  the  neck,  in  order  to   show  their  courses  more 


MANUAL   OF  BANDAGING.  49 

plainly.     In  other  words,  they  are  too  angular,   as  represented  in 
the  cut. 


DOUBLE  POSTEEIOE  T  OF  THE  HEAD  AND  THORAX. 

Description. — Same  as  Double  Anterior  T  of  the  Head  and 
Thorax,  page  50. 

Application. — The  reverse  of  that  bandage,  the  head  being 
flexed  backwards;  the  application  is  then  essentially  the  same  as  seen 
in  cut  No.  35. 

Uses. — The  same  as  those  of  the  Posterior  Figure  of  8  of  the 
Head  and  the  Axillae,  and  may  be  preferred  to  it. 


FEONTO-DOESAL   TEIANGLE. 

Description. — The  same  as  the  Occipito-Sternal  Triangle 
described  on  page  51. 

Application. — The  reverse  of  the  Occipito-Sternal  Triangle. 
Imagine  your  patient  to  be  with  his  back  to  you,  in  Fig.  36,  and  the 
application  will  then  be  readily  understood,  as  it  is  so  similar. 

Uses. — Mayor  designed  this  to  take  the  place  of  the  Posterior 
8  of  the  Head  and  Axillae,  and  the  Double  Posterior  "f  of  the  Head 
and  Thorax,  which  it  does  admirably. 


ANTEEIOE  FIGUEE  OF  8  OF  THE   HEAD   AND  THE  AXILLA. 

Description. — This  bandage  should  be  nine  yards  in  length  by 
one  and  three  quarter  inches  in  width. 

Application. — See  Fig.  34.  This  bandage  is  to  be  applied 
just  the  reverse  to  this  ;  that  is,  stand  in  front  of  your  patient,  and 
place  the  initial  end  at  the  forehead,  flexing  the  head  forwards  upon 
the  chest. 

Uses. — In  cases  of  bums  of  the  back  of  the  neck,  or  upper  por- 
tion of  the  back  where  vicious  cicatricial  contraction  is  to  be  feared. 
Also  for  transverse  wounds  of  the  front  part  of  the  neck.  This  band- 
age is  not  often  employed  on  account  of  the  inconvenience  from  the 


50 


BANDAGES  OF  THE  NECK. 


crossings  of  the  bandage,  which  occur  upon  the  patient's  face.  Either 
the  following,  or  the  Occipito-sternal  Triangle,  is  to  be  preferred 
to  it. 

DOUBLE  ANTERIOR  T  OF  THE  HEAD  AND  THORAX. 
Description. — I.  A  broad  band,  eight  or  ten  inches  wide,  and 
sufficiently  long  to  encircle  the  chest. 

II.  Two  shoulder  strips  to  act  as  "  suspenders  "  of  this  broad 
thoracic  band. 

III.  A  bandage  three  yards  long  and  one  and  three-quarter  inches 
wide.  To  the  superior  border  of  this  bandage,  at  a  distance  of  twenty 
inches  from  the  initial  end,  is  to  be  sewed  (at  right  angles)  a  strip 
two  feet  long,  by  one  and  one  quarter  inches  wide.  To  the  inferior 
border  (at  nearly  right  angles)  are  to  be  sewed  two  strips,  each 
eighteen  inches  long  by  one  inch  wide,  at  three  inches  distant, 
each  way,  from  the  lateral  borders  of  the  strip  sewed  to  the  superior 
border  of  the  main  bandage  ;  thus  having  some  eight  inches  inter- 
vening between  the  two  inferior  strips. 

Application. — Encircle  the  thorax  with  the  broad  band,  a,  con- 
riG.  35.  fining  by  pins  or  stitches ;  and  to 

it  pin  the  "  suspenders  "  b,  b'. 
This  done,  place  the  initial  end 
of  the  roller  upon  the  forehead, 
c-i,  and  confine  by  a  horizon- 
tal turn,  2 ;  carry  the  single 
band,  d,  up  over  the  top  of  the 
head  and  down  under  the  hori- 
zontal course  of  the  main  band- 
age, at  the  occiput,  again  re- 
mounting the  head  and  confin- 
ing with  a  pin  or  stitches.  After 
this,  exhaust  the  roller,  c,  by 
horizontal  courses  about  the 
forehead  and  occiput.  After 
doing  this,  flex  the  head  upon 
the  chest,  to  that  degree  deem- 

Doubie  Anterior  T  of  the  Head  and  Thorax,   ed  requisite,  and  confine  it  there 

by  pinning  the  strips  e',  e,  to  the  thoracic  band,  a. 


MANUAL    OF  BANDAGING.  51 

Uses. — Same  as  those  of  the  Anterior  Figure  of  8  of  the  Head 
and  Axillae,  and  is  to  be  preferred  to  it. 


OCCTPITO-STERNAL  TRIANGLE. 

Description. — I.  A  triangle  one  yard  long  and  having  a  height 
of  eighteen  inches, 

II.  A  triangle  of  the  same  size  folded  to  a  cravat. 

Application. — Place  the  centre  of  the  cravat  at  the  sternum, 
FIG-  36.  and  conduct  both  ends  back- 

wards, under  the  axillas,  and 
confine  with  a  knot,  at  the  back. 
Place,  now,  the  centre  of  the 
base  of  the  triangle  at  the  fore- 
head, carry  the  two  extremities 
backwards,  over  the  apex  of  the 
triangle,  to  the  occiput,  crossing 
them  here  to  conduct  them  for- 
wards, and  obliquely  downwards 
to  the  sternum,  after  having 
pinned  them  at  the  sides  of  the 
head.  Flex  the  head  sufficient- 
ly, and  then  tie  them  about  the 
Occipito-sternai  Triangle.  cravat.     The   apex  of  the   tri- 

angle can  be  confined  as  in  ordinary  cases. 

Uses. — Mayor  designed  this  bandage  to  take  the  place  of  the 
Anterior  8  of  the  Head  and  Axillse,  and  the  Double  Anterior  T  of 
the  Head  and  Chest,  which  it  does  admirably ;  and  for  readiness  of 
application,  and  the  abundant  security  it  gives,  it  is  to  be  preferred 
to  them. 


52 


BANDAGES    OF   THE  NECK. 


FIG.    37. 


FIGUKE  OF  8  OF  THE  HEAD  AND  AXILLA, 

(Lateral  Bandage  of  the  Neck.) 

Description. — This  bandage  should  be  six  yards  long  by  one 
and  three-quarters  inches  wide. 

Application. — Standing  behind  your  patient,  place  the  initial 

end,  I,  at  the  forehead,  and 
confine  by  a  single  horizontal 
turn,  2.  Having  arrived  at  the 
occiput,  on  the  third  course, 
flex  the  patient's  head  on  the 
side  injured,  the  right  for  in- 
stance, and  carry  the  bandage 
down  in  front  of  the  right  shoul- 
der to  the  axilla,  thus  finishing 
turn  3.  Continue  the  course  of 
the  bandage  on  beneath  the 
right  axilla,  and  up  to  the  fore- 
head ;  here  reverse  and  confine 
with  a  pin,  thus  finishing  turn 
4.  Turn  5  is  to  be  in  the  course 

Figure  of  8  of  the  Head  and  Axilla.  ^^  ^^^^  ^^  ^^^^  ^  ^f  ^^^^  ^^  ^^d 

so  on.     At  last  exhaust  the  bandage  by  horizontal  turns  about  the 
forehead  and  occiput,  or  the  right  arm,  as  a',  or  a. 

Uses. — In  cases  of  burns  of  the  side  of  the  neck  where  vicious 
cicatricial  contraction  is  feared ;  or,  of  transverse  wounds  of  the  sides 
of  the  neck,  when  gaping  would  otherwise  persist. 


PAEIETO-AXILLARY    TEIANGLE    AND    CRAVAT. 

(Lateral  Tria?igle  of  the  Neck.) 

Description. — I.  A  triangle  having  a  base  one  yard  in  length, 
with  a  height  of  sixteen  inches. 

II.  A  triangle  of  same  size  folded  to  a  cravat. 


MANUAL    OF  BANDAGING. 


53 


Application. — Pass  the  cravat,  a,  under  the  left  axilla,  supposing 
FIG.  38.  you  wish  to  incline  the  head  to 

the  left,  and  tie  in  front  of  the 
shoulder.  Place  the  base  of  the 
triangle,  b,  over  the  left  parietal 
region,  and  carry  the  two  extre- 
mities horizontally  around  the 
head,  cross  them,  flex  the  head 
towards  the  left  shoulder,  and 
bring  them  down  and  tie  to  the 
cravat.  Confine  the  apex  of  the 
triangle  with  a  pin,  as  usual. 

Uses. — This  bandage  of 
Mayor  fully  takes  the  place  of 
the  preceding,  and  is  far  prefer- 
able to  it,  so  far  as  ease  of  ap- 
plication and  removal  is  concerned.  It  is  equally  efficacious  in 
restraining  the  movements  of  the  head.  May  be  applied  to  either 
side  of  the  head. 


Parieto-Axillary  Triangle  and  Cravat. 


54 


BANDAGES    OF   THE   UPPER  EXTREMITY. 


CHAPTER   VII. 


BANDAGES    OF    THE    UPPER   EXTREMITY. 


SPIRAL    OF    ONE    FINGER. 


Description. — This  bandage  should  be  one  and  one-half  yards 
in  length  by  three-quarters  of  an  inch  in  width. 

Application. — Suppose  it  is    the  right  fore-finger  to  which 
FIG.  39.  you  wish  to  apply  the  bandage.     Pronate 

the  hand;  after  unrolling  four  or  five 
inches  of  the  bandage,  place  it  upon  the 
back  of  the  wrist,  as  i,  and  confine  it  by 
a  single  circular  turn,  2.  Continue  the 
course  of  the  bandage  about  the  wrist  till 
you  come  to  the  ulnar  border,  when  you 
cross  down  the  back  of  the  hand  (course 
3)  and  continuing  the  course  of  the  band- 
age onwards  along  the  radial  side  of  the 
forefinger,  you  encircle  this  at  the  tip, 
as  course  4.  Courses  5,  6,  7,  8,  9,  10  and 
1 1  encircle  the  diseased  member  spirally ; 
while  course  12  runs  obliquely  upwards, 
spiraiiof  one  Finger.  ^^^^  ^^^  ^^^^  finger-cleft,  across  the  back 

of  the  hand  to  the   radial  side  of  the  wrist,  partially  encircling  it, 
when  you  tie  both  extremities,  as  at  13. 

Uses. — For  maintaining  the  coaptation  of  severed  parts,  when 
there  is  a  longitudinal  wound ;  also  for  confining  dressings  and 
splints  to  the  part  This  bandage  is  applied  to  any  one  of  the 
fingers,  or  the  thumb,  of  either  hand. 


MANUAL   OF  BANDAOJNO. 


55 


POSTERIOR   FIGURE  OF  8  OF  THE  THUMB  AND  WRIST. 

(Spica  of  the  Thumb.) 

Description. — This  bandage  should  be  two  yards  in  length  by- 
three-quarters  of  an  inch  in  width. 

Application. — If  it  be  the  right  you  wish  to  bandage,  place  the 
FIG.  40.  hand  midway  between  pronation  and  su- 

pination. Unroll  four  or  five  inches  of  the 
bandage,  and  thus  place  it,  i,  upon  the 
back  of  the  wrist,  and  confine  by  two  cir- 
cular turns,  2  and  3  ;  continue  on  in  the 
same  course  till  you  come  to  the  ulnar 
border  of  the  hand,  when  you  descend 
obliquely  across  the  back  of  the  hand  to 
the  radial  side  of  the  thumb,  at  the  pha- 
langeal articulation,  thus  finishing  course 
4.  Pass  under  the  thumb  and  then  up 
over  it,  and  diagonally  upwards  to  the 
radial  side  of  the  wrist,  finishing  course  5. 
Turns  6,  8,  10,  12  and  14,  etc.,  respec- 
tively follow  the  course  of  turn  4 ;  while 
those  of  7,  9,  II,  13  and  15,  those  of  turn 
5.  At  last  exhaust  the  bandage  by  circular  turns  about  the  wrist, 
and  confine  by  tying. 

Uses. — For  confining  dressings  to  the  back  of  the  thumb,  or  the 
first  metacarpal  space ;  also  as  dressing  after  the  reduction  of  a 
dislocation  of  the  first  phalanx.  It  can  be  applied  so  that  the  spiral 
shall  run  downwards,  instead  of  upwards^  as  we  have  given  ;  but  the 
descending  spiral  can  rarely  be  put  on  so  evenly  and  regularly. 


Posterior  Figure  of  8  of  the 
Thumb  and  Wrist. 


POSTERIOR  FIGURE  OF  8  OF  THE  HAND  AND  WRIST. 

Description. — -This  bandage  should  be  one  and  one-half  yards 
in  length  by  one  and  one-quarter  inches  in  width. 


56 


BANDAGES  OF  THE   UPPER  EXTREMITY. 


Application. — ^Place  the  initial  end,  i,  on  the  back  of  the  wrist 
^^^-  '*^-  — the  left,  for  example, — and  confine  by 

a  circular  turn,  2  ;  continue  the  course  of 
the  bandage  about  the  wrist  till  you  come 
to  the  radial  border,  when  you  descend 
obliquely  across  the  back  of  the  hand  to 
the  fifth  metacarpo-phalangeal  articula- 
tion, thus  finishing  turn  3.  Turn  4  is  a 
circular  course  about  the  metacarpo-pha- 
langeal articulations ;  whilst  course  5 
ascends  obliquely  across  the  hand,  from 
the  radial  border  of  the  fore-finger,  to  the 
ulnar  border  of  the  wrist.  Turn  6  is  a 
simple  circle  of  the  wrist.  Course  7  is  in 
line  of  course  3,  slightly  overlapping  it ; 
course  8,  in  line  of  course  4 ;  course  9,  ot 
course  5.  Exhaust  the  bandage,  at  last,  by 
simple  circles  about  the  wrist,  and  confine  in  the  ordinary  way. 

Uses. — For  confining  dressings  to  the  back  of  the  hand  or  ^vrist, 
as  cataplasma,  graduated  compresses  over  ganglionic  cysts,  etc.;  also 
as  an  after-dressing  after  a  dislocation  backwards  of  the  os  magnum, 
or  any  of  the  dislocations  backwards  of  the  first  row  of  phalanges. 


Posterior  Figure  of  8  of  the 
Hand  and  Wrist. 


ANTEKIOE  FIGUEE  OF  8  OF  THE  HAND  AND  WKIST. 


Description. — This  bandage  should  be  one  and  one-half  yards 
long  by  one  and  one-quarter  inches  wide. 

Application. — Just  the  reverse  of  that  seen  in  figure  41  > 
that  is,  imagine  the  palm  of  the  hand  presenting,  and  then  apply  as 
above  described. 

Uses. — To  confine  dressings  to  the  palm  of  the  hand,  and  to 
the  anterior  surface  of  the  ^v^ist ;  also,  to  confine  compresses  to  the 
region  of  the  palmar  arches,  in  case  the  vessels  are  wounded,  and 
ligation  is  called  for. 


MANUAL  OF  BANDAGING.  57 

FOUR-TATLED  BANDAGE  OF  THE  HAND. 

( Sling  of  the  Hand.) 

Description. — -This  bandage  should  be  eighteen  inches  in 
length  by  three  or  four  inches  in  width. 

Application. — Fold  the  ends  together,  and  then  tear,  or  cut 
them  back  to  within  two  inches  of  the  folded  centre,  thus  making  a 
bandage  similar  to  the  compress  seen  in  figure  4,  page  17.  Place 
the  plane  of  the  bandage  either  upon  the  palm  or  the  back  of  the 
hand,  according  to  the  seat  of  injury.  Tie  the  inferior  ends  about 
the  metacarpo-phalangeal  articulations ;  whilst  the  superior  ends  you 
carry  obliquely  upwards  to  the  wrist,  and  confined  there  by  tying 
about  it. 

Uses. — This  bandage  is  intended  to  take  the  place  of  the  Pos- 
terior and  Anterior  Figure  of  8's  of  the  Hand  and  Wrist,  in  injuries 
about  the  palm  or  the  back  of  the  hand.  As  it  is  more  easily  ap- 
plied, it  has,  perhaps,  become  a  more  general  favorite.* 


DOUBLE  T  OF  THE  BACK  OF  THE  HAND  AND  WKIST. 

Description.— The  main  bandage,  a,  should  be  some  twenty- 
FiG.  42.  eight  inches  in  length  by  one  inch  in  width.     At 

a  distance  of  three  inches  from  the  initial  end, 
stitch,  at  right  angles,  another  bandage,  B,  twenty 
inches  long,  by  three-quarters  of  an  inch  wide ;  at 
a  point  two  inches  from  this,  stitch,  at  right 
angles  to  the  plane  of  the  main  bandage,  and 
^"'^l^^'"^  parallel  to  b,  another  bandage,  c,  of  the  same 
dimensions  as  b. 

Application.— Place  the  initial  end  of  the  bandage,  a,  upon 


Note. — The  systems  of  Triangles  and  Cravats  are  so  readily  applied  to  the 
hand,  and  are  in  such  common  use  by  the  laity,  even,  no  description  of 
them  is  thought  necessary. 


58 


BANDAGES    OF   THE   UPPER  EXTREMITY. 


Double  T  of  the  Back  of  the 
Hand  and  Wrist. 


FIG.  43.  the  back  of  the  wrist,  so  that  the  first 

perpendicular  portion  of  the  bandage, 
B,  will  correspond  to  the  first  interosse- 
ous space,  and  the  portion  c,  with  the 
fourth  interosseous  space.  Confine  the 
initial  end  by  a  single  circular  turn,  2, 
about  the  wrist.  Carry  the  portion  b 
down  the  first  interosseous  space,  around 
over  the  palmer  surface  of  the  first  joint 
of  the  index  finger,  and  then  back, 
over  the  second  interosseous  space, 
to  the  wrist;  this  done,  make  another 
circular  turn  about  the  wrist  with  the 
main  bandage,  as  turn  3,  running  over 
the  recurrent  portion  of  b  at  the  wrist. 
Continue  these  circular  turns  of  a  until  the  bandage  is  exhausted, 
when  confine  with  a  pin.  Conduct,  now,  the  other  perpendicular 
portion,  c,  down  the  fourth  interosseous  space,  across  the  palmer 
surface  of  the  metacarpo-phalangeal  articulation  of  the  ring-finger, 
back,  over  the  third  interosseous  space,  to  the  wrist,  here  tying  with 
the  end  01  the  first  portion,  b,  as  at  d,  after  the  requisite  amount  of 
extension  of  the  palmar  tissues,  or  fingers,  has  been  obtained. 

Uses. — In  cases  of  bums  of  the  palm  of  the  hand,  or  extensive 
suppurations,  where  vicious  cicatricial  contractions  are  to  be  feared. 
In  cases  of  injuries  of  the  finger-clefts,  from  bums  or  otherwise ;  here 
using  compresses,  soaked  in  carbolized  oil,  to  prevent  the  union  of 
the  sides  of  the  fingers  from  "  angular "  granulation.  Also  for  con- 
fining dressings  to  the  back  of  the  hand. 

Variety. — Single  T  of  the  Back  of  the  Hand  and  Wrist. — In  this 
case  but  one  perpendicular  portion  of  the  bandage  is  used,  as  b,  or 
c ;  it  being  applied  between  any  finger-clefts  desired,  and  in  a  manner 
similar  to  the  above. 

The  uses  are  similar  to  the  Double  f  just  described,  only  are 
more  limited. 


MANUAL    OF  BANDAGING . 


59 


Diagram. 


PERFORATED   J  OF   THE   HAND   AND   WRIST. 

FIG.  44.  Description.— A  bandage,  a,  a',  eighteen 

inches  in  length  by  one  inch  in  width.  At 
the  middle  of  this,  at  right  angles  to  it,  stitch 
a  piece  of  linen,  or  flannel,  b,  twelve  inches  in 
length  by  four  inches  in  width,  having  five 
perforations ;  the  first,  corresponding,  from  its 
size  and  position,  with  the  thumb,  as  c.  The 
other  perforations  are  made  at  such  distance 
from  each  other,  and  of  such  size,  as  will  read- 
ily admit  the  fingers. 
Application.— Suppose  it  to  be  the  right  hand.  Carry  the 
FIG.  45.  fingers  and  thumb  through  their  respec- 

tive perforations  in  the  portion  b,  and 
place  the  portion  a  at  the  back  of  the 
wrist.  Carry  forwards  the  lower  portion 
of  B  (see  figure  44),  up  across  the  palm 
of  the  hand,  folding  it  about  the  wrist, 
as  D,  d'.  Conduct,  now,  the  two  extre- 
mities of  the  main  bandage  (a,  a',  figure 
44)  circularly  about  the  wrist,  binding 
down  the  recurrent  portion  of  b  (d,  d'); 
and  when  exhausted,  tie  the  ends  to- 
gether, as  at  c. 

Uses. — Designed  to  take  the  place 
of  the  Double  or  Single  7"  Bandage  of 
the  Hand  and  Wrist ;   also  for  confining 

Perforated  T  of  the  Hand  and     dressings  to  the  palm  of  the  hand  as 
Wrist.  ' 

well  as  to  the  dorsal  portion. 


CARPO-DIGITO-PALMAR  TRIANGLE. 

Description.— This  should  be  a  triangle  having  a  base  twenty- 
four  inches  in  length  and  a  height  of  twelve  inches. 


60 


BANDAGES    OF   THE    UPPER   EXTREMITY. 


Application. 

FIG.   46. 


Carpo-Digifx)-Palinar 
Triangle. 

back  of  the  hand. 


Place' the  base  of  the  triangle  upon  the  palmar 
surface  of  the  wrist ;  conduct  both  extremi- 
ties circularly  around  the  wrist,  tying  at  the 
back.  Fold  the  sides  of  the  triangle  over 
the  dorsum  of  the  hand,  and  carry  the  apex 
of  the  triangle  up  over  the  back  of  the  fingers 
(extending  them  as  circumstances  demand) 
to  the  wrist,  as  at  b,  there  confining. 

Uses.— For  maintaining  dressings  to  the 
palm  of  the  hand,  and  also  for  extending  the 
fingers  upon  the  forearm,  in  cases  of  burns  of 
the  palm,  where  vicious  cicatrization  is  to  be 
feared;     also  in   transverse   wounds    of  the 

In  these  latter  cases  it  takes  the  place  of  the 


Double  X  of  the  Back  of  the  Hand  and  Wrist. 

DOUBLE  ANTERIOR  T  OF  THE  HAND  AND  WRIST. 

Description. — The  same  as  the  Double  T  of  the  Back  of  the 
Hand  and  Wrist  (page  57). 

Application.- — The  reverse  of  the  Double  T  of  the  Back  of 
the  Hand  and  Wrist ;  that  is,  it  is  to  be  applied  to  the  /ro/i/  of  the 
hand. 

Uses. — Similar  to  the  above  in  cases  of  finger-cleft  injuries,  or 
after  web-finger  operations.  Also  in  cases  of  burns  across  the  back 
of  the  metacarpo-phalangeal  articulations,  or  transverse  wounds 
across  the  front  of  the  same  joints. 

Variety. — Single  Anterior  T  of  the  Hand  and  Wrist. — Only  one 
perpendicular,  or  finger-cleft,  portion  of  the  bandage  is  to  be  used. 
It  can  be  applied  to  any  of  the  finger-clefts  desired. 

The  uses  are  similar  to  the  Double  T?  o^^Y  "^ore  limited. 


CARPO-DIGITO-DORSAL    TRIANGLE. 

Description. — Same  as  Carpo-Digito-Palmar  Triangle. 
Application. — The  reverse  of  that  seen  in  figure  46,  in  that 
you  place  the  base  of  the  triangle  at  the  back  of  the  wrist,  confining 


MANUAL  OF  BANDAGING. 


61 


as  in  the  preceding  case.  Afterwards  fold  the  apex  up  over  the  palm 
of  the  hand,  thus  flexing  the  lingers  upon  the  forearm,  and  confine 
at  the  wrist. 

Uses. — For  maintaining  dressings  upon  the  hand,  and  for  main- 
taining the  fingers  in  a  state  of  flexion  when  vicious  cicatrization  is 
to  be  feared  upon  the  back  of  the  hand ;  also,  in  cases  of  transverse 
wounds  of  the  palm  of  the  hand.  It  is  then  designed  to  take  the 
place  of  the  Double  Anterior  "J"  of  the  Hand  and  Wrist. 


SPIRAL    OF    ALL    THE    FINGEES. 

(Gauntlet.) 

Description. — This  should  be  a  bandage  ten  yards  in  length 
by  three-quarters  of  an  inch  in  width. 

Application. — Suppose  it  be  the  right  hand  to  which  it  is  to  be 
FIG.  47.  applied.  After  letting  drop  four 

or  five  inches  (enough  to  tie 
with)  of  the  initial  end,  place 
the  bandage  upon  the  back  of 
the  wrist,  i,  and  confine  by  the 
circular  turns,  2  and  3  ;  after- 
wards coming  obliquely  down 
across  the  back  of  the  hand, 
from  the  radial  side,  to  the  little 
finger,  finishing  course  4.  Con- 
tinue the  bandage  outwards  to 
the  tip  of  this  finger,  making  a 
circular  turn,  5,  and  the  spiral 
turns  6,  7,  8,  9,  10,  11,  12,  13 
and  14  about  the  same  member ; 
then  conduct  the  bandage  up- 
wards  and  outwards  from  the 

Spiral  of  all  the  Fingers.  c       ^\.  c  ^   c^  .     .\  1 

fourth  finger-cleft  to  the  palmar 
surface  of  the  wri^t,  thus  finishing  course  15.  Course  16  is  essen- 
tially that  of  course  4,  with  this  difference  :  it  goes  to  the  ring  finger; 
this  finger  is  spirally  bandaged,  and  the  recurrent  course,  27,  of  the 
bandage  is  similar  to  that  ot  course  15.  Each  of  the  remaining 
9 


62 


BANDAGES  OF  THE   UPPER  EXTREMITY. 


fingers  are  similarly  wound,  and  at  last  both  ends  of  the  bandage  are 
tied  at  the  back  of  the  wrist,  or  forearm,  62. 

Uses. — In  cases  of  fracture,  or  dislocation  of  the  phalanges;  and 
burns,  or  other  wounds  of  the  fingers  and  hand,  where  vicious  cica- 
tricial contraction  is  to  be  feared,  or  after  an  operation  for  web- 
finger. 


FIG.  48. 


SPIRAL    OF    THE    FINGERS    AND    THE    HAND. 

Description. — This  bandage  should  be  three  yards,  or  more, 
in  length,  and  one  and  one-quarter  inches  in  width. 

Application. — Place  the  initial  end  of  the  bandage,  i,  at  or 
near  the  extremities  of  the  fingers,  and 
confine  by  the  spiral  turn  2  ;  make  six 
other  spiro-circular  turns  about  the 
fingers,and  on  the  9th,  loth,  nth,  12th, 
etc.,  courses  make  the  reverse  to  each 
turn,  so  as  to  accommodate  the  obli- 
quity of  the  thumb,  and  thus  prevent 
the  bandage  slipping  off.  At  last  ex- 
haust by  simple  circular  turns  about 
the  wrist,  or  lower  part  of  the  forearm, 
and  confine  with  the  pin  as  usual. 

Uses. — In  cases  of  fracture,  or  dis- 
location, of  the  phalanges ;  and  also  for 
confining  dressings  to  any  part  of  the 
hand  and  wrist.  If  the  fingers  should 
each,  separately,  demand  compression, 
then  the  Spiral  of  All  the  Fingers  (The 
Gauntlet)  should  be  employed. 


Spiral  of  the  Fingers  and  the 
Hand. 


THE  SHEATH  OF  THE  FINGERS. 

Description. — Instead  of  the  more  elaborate  ones  recom- 
mended by  some  authors,  you  can  use  the  fingers  from  a  large  glove; 
or,  if  the  whole  hand  is  to  be  enveloped,  a  mitten. 


MANUAL   OF  BANDAGING.  63 

Uses. — In  the  simpler  injuries  about  the  hand  where  the  more 
complex  bandages  are  hardly  called  for. 

FIGUEE  OF  8  EXTENSOE  OF  THE  HAND  UPON  THE  FOEEAEM. 

Description.— This  bandage  should  be  six  yards  in  length  by 
one  and  a  half  inches  in  width,  and  rolled  into  two  equal  heads. 
Application. — Place  the  plane  of  the  roller  upon  the  back  of 
PIG.  49.  the  hand,  i,  conduct  both  heads 

to  the  palm,  cross  them,  one 
above  the  other,  and  remount 
to  the  back,  crossing  them 
there,  2  2,  and  conduct  them 
to  the  palm  again.  Re-crossing 
them,  carry  the  heads  upwards 
across  the  arm,  3,  3,  to  a  point 
above  the  olecranon  process, 
the  hand  being  sufficiently  ex- 
tended ;  make  a  circle  of  the 
arm  at  this  point,  4,  4,  crossing 
the  heads  before  and  behind, 
and  at  last  descend  upon  the 
arm  again,  5,  5,  to  make  another 
circuit  about  the  hand,  thence 
to  remount  to  the  elbow  again. 
Finally  exhaust  both  heads  by 
Figure  of  8  Extensor  of  the  Hand  upon  the  circular  turns  above  the  elbow, 
Forearm.  Confining  as  usual. 

Uses. — In  cases  of  burns  of  the  palmar  surface  of  the  hand,  wrist 
or  forearm,  where  vicious  cicatricial  contraction  is  to  be  feared,  and 
in  all  other  cases,  where  extension  of  the  hand  upon  the  forearm  is 
desired,  as  in  transverse  wounds  of  the  back  of  the  wrist. 

FIGUEE  OF  8  FLEXOE  OF  THE  HAND  UPON  THE  FOEEAEM. 

Description. — This  bandage  should  be  six  yards  in  length  by 
one  and  a  half  inches  in  width,  and  rolled  into  two  equal  heads. 


64 


BANDAGES    OF   THE    UPPER   EXTREMITY. 


Application. — -Similar  to  the  preceding ;  the  plane  of  the 
bandage  being  placed  at  the  palm  of  the  hand,  the  member  being 
flexed  upon  the  forearm.  Courses  i  and  2  are  to  be  made  as  in  the 
Extensor  of  the  Figure  of  8  of  the  Hand  upon  the  Forearm,  and  the 
heads  carried  above  the  elbow  and  the  remaining  courses  made  in 
a  similar  manner  to  those  of  the  preceding  bandage. 

Uses. — In  maintaining  forward  flexion  of  the  hand  upon 
the  forearm,  as  in  case  of  burns  of  the  back  of  the  hand,  wrist  and 
forearm,  where  vicious  cicatricial  contraction  is  to  be  feared.  Also 
in  cases  of  transverse  wounds  of  the  forepart  of  the  wrist,  where  a 
tendency  to  gaping  occurs. 


CAEPO-OLECEANON    CEAVAT. 

Description." — I.  Two  cravats,  each  eighteen  inches  in  length. 

II.  A  third  cravat,  thirty-six  inches  in  length. 

FIG.  50.  Application. — Tie  one  of 

the  short  cravats  about  the 
hand,  as  at  a  ;  and  then  tie 
the  other  about  the  arm,  above 
the  olecranon  process,  as  at 
B.  Extend,  now,  the  hand 
upon  the  forearm,  and  confine 
it  by  tying  the  long  cravat,  c, 
between,  and  to,  them. 

Uses. — Same  as  the  Figure 
of  8  Extensor.  As  these  cravats 
are  easier  applied,  and  full  as 
safe  as  the  roller  bandage,  they 
are  to  be  recommended  to  it. 
Variety. — If  need  be,  a 
Flexor  variety  of  this  cravat 
may  be  employed.  In  this 
case,  the  hand  is  flexed  upon 
the  anterior  surface  of  the 
forearm,  by  running  the  long 
cravat,  c,  down  the  a?iterior 
surface  of  the  member.     This 


Carpo-Olecranon  Cravat. 


MANUAL    OF  BANDAGING.  65 

bandage  would  then  take  the  place  of  the  Figure  of  8  Flexor  of  the 
Hand  upon  the  Forearm,  just  described. 


SIMPLE    SPIRAL    OF    THE    FOREAEM. 

Description. — This  bandage  should  be  two  yards  in  length 
by  one  and  a  half  inches  in  width. 

■  Application. — Place  the  initial  end  at  the  wrist  and  confine 
by  a  circular  turn  above  it ;  exhaust  the  bandage  by  encircling  the 
arm  with  spiraliform  turns,  as  you  see  in  the  upper  courses  of  the 
bandage  depicted  upon  page  62. 

Uses. — To  retain  dressings  upon  the  forearm. 

REVERSED    SPIRAL  OF  THE  SUPERIOR  EXTREMITY. 

(Roller  of  the  Superior  Extremity.) 

Description. — This  should  be  twelve  yards  in  length  by  one 
and  a  half  inches  in  width. 

Application. — See  figure  10,  page  22.  This  bandage  is  to 
be  applied  as  here  represented,  the  courses  being  continued  upwards 
to  the  axilla ;  here  confining  in  the  usual  way. 

Uses. — Most  generally  employed  in  cases  of  fractures,  etc.,  to 
restrain  muscular  action,  swelling,  and  to  favor  the  return  of  venous 
blood  to  the  vena  cava  superior.  When  employed,  the  surgeon 
should  guard  himself  that  he  does  not  allow  unequal  pressure  at  any 
of  the  courses  of  the  bandage.  Should  he  have  one  part  of  the  member 
more  tightly  constricted  than  another,  he  will  only  increase  the  mis- 
chief already  done  by  the  accident  by  favoring  the  development  of 
gangrene,  from  venous  stagnation,  at  the  more  constricted  portions. 
When  evenly  and  smoothly  applied,  this  bandage  is  of  great  service 
to  the  surgeon ;  when  inaptly  applied,  a  source  of  great  danger  to  his 
patient,  and  chagrin  to  himself.  (See  note  at  foot  of  page  67). 

ANTERIOR   FIGURE    OF    8    OF    THE    ELBOW. 

Description. — This  bandage  should  be  two  and  a  half  yards  in 
length  by  one  and  a  half  inches  in  width. 


66 


BANDAGES    OF   THE   UPPER  EXTREMITY. 


Anterior  Figure  of  8  of  the 
Elbow. 


Application. — Suppose  it  to  be  the  right  arm  to  be  bandaged. 
FIG.  51.  Place  the  initial  end  of  the  bandage,  i, 

above  the  bend  of  the  elbow,  and  confine 
by  a  single  circular  turn,  2.  Continue  on 
in  the  same  direction  till  you  get  to  the 
outside  of  the  arm,  when  you  descend 
diagonally  across  the  front  of  the  joint, 
to  a  point  four  or  five  inches  below  it, 
thus  finishing  turn  3.  Turn  4  is  a  circu- 
lar course  about  the  upper  portion  of  the 
forearm ;  turn  5,  a  spiral  turn  upwards  to 
the  inside  of  the  arm  above  the  bend  of 
the  elbow ;  whilst  turn  6  is  in  course  ot 
turn  3  ;  turn  7,  of  course  5,  and  so  on ;  at 
last  exhaust  by  circular  turns  about  the 
arm,  and  confine  as  usual. 

A  variation  can  be  made,  and  to  good  advantage  sometimes,  by 
making  course  6  to  be  a  circular  turn  about  the  arm,  as  course  2  ; 
course  7  then  being  the  same  as  course  6  in  the  figure,  whilst  course 
8  is  a  circle  of  the  forearm,  as  course  4  in  the  wood-cut ;  course  9 
would  then  take  the  place  of  course  7  in  the  cut. 

Uses. — Generally  to  fix  a  compress  over  the  median-cephalic 
vein  after  venesection.  Can  be  employed  in  cases  of  wounds  in  that 
region,  or  for  maintaining  dressings  thereto. 

Variety. — By  making  similar  courses  of  the  bandage  upon  the 
posterior  surface  of  the  arm  and  forearm,  you  get  the  Posterior  Fig- 
ure of  8  of  the  Elbow. 

The  Uses  of  this  variety  are  essentially  to  confine  dressings  about 
the  back  of  the  joint. 

A  Triangle  of  the  Elbow  and  also  a  Four-tailed  Bandage  (Anterior 
and  Posterior)  have  been  devised  to  take  the  place  of  the  roller  var- 
ieties. But  these  are  so  readily  applied  that  no  further  description 
is  necessary. 


CERVICO-ULNAE    CEAVAT    AND    TRIANGLE. 
Description. — I.  There  should  be  a  cravat  two  feet  in  length. 


MANUAL    OF  BANDAGING. 


67 


II.  A  triangle  having  a  base  of  two  feet,  and  a  height  of  twelve 

inches. 

Application. — Tie   the   cravat  a,  about  the  neck.     Flex  the 
FIG.  52.  forearm,    at    right    angles, 

upon  the  arm ;  then  place 
the  base  of  the  triangle 
at  the  ulnar  border  of  the 
hand,  the  apex,  b,  being  at 
the  elbow,  and  tie  the  two 
extremities  of  the  triangle 
into  the  cravat  of  the  neck, 
as  at  c. 

Uses.- — In  cases  of 
bums  of  the  back  part  of 
the  elbow  or  transverse 
wounds  of  the  front  of  the 
joint ;  also,  as  a  "sling",  in 

cases  of  injuries  of  the  forearm,  or  hand,  where  elevation,  or  "  rest ", 

of  the  part  may  seem  demanded.     It  may,  or  may  not,  be  applied 

over  the  clothing. 


Cervico-Ulnar  Cravat  and  Triangle. 


SPIEAL    OF    THE    AKM. 

Description.-  -This  bandage  should  be  one  and  one-half  yards 
in  length  by  one  and  a  half  inches  in  width. 

Application. — Essentially  the  same  as  that  of  the  Spiral  of  the 
Forearm,  described  upon  page  65,  except  that  you  begin  at  the 
elbow. 

Uses. — To  confine  dressings  to  the  arm-regions,  or  for  the  sup- 
port of  the  edges  of  longitudinal  wounds,  thus  securing  coaptation. 
It  may  or  may  not  be  applied  with  "  reverses  ";  yet,  should  the  biceps 
be  well  developed,  it  would  be  best  to  employ  them,  otherwise  the 
bandage  would  be  in  great  danger  of  slipping  down.* 


Note. — See,  for  all  of  these  Spiral  bandages,   the  description  of  the 
Figure  of  8  Spiral  of  the  Extremities  described  upon  a  following  page. 


68 


BANDAGES    OF   THE    UPPER  EXTREMITY. 


FOUE-TAILED    BANDAGE    OF    THE    SHOULDEE. 

Description. — This  should  be  a  piece  of  cloth  some  forty-eight 
inches  in  length  and  five  or  six  inches  in  width.  Fold,  lengthwise, 
at  the  centre,  and  then  cut,  or  tear,  back  the  extremities  to  within 
four  or  five  inches  of  this  point,  thus  shaping  it  something  like  the 
"  sling  compress,"  figure  4,  page  17. 

Application. — Place  the  plane  of  the  bandage  over  the  diseased 
shoulder,  and  carry  the  two  superior  ends  of  the  bandage  obliquely 
down  across  the  chest  (one  upon  its  anterior,  and  the  other  upon  its 
posterior  surface)  and  tie  them  below  the  opposite  axilla.  Then 
carry  the  two  inferior  extremities  of  the  bandage  up  around  the  neck 
(one  in  front  and  the  other  behind),  and  confine  them  by  tying. 

Uses. — To  confine  dressings  about  the  shoulders.  It  furnishes  a 
very  handy,  though  not  very  firm  variety  of  dressing. 


FIG.  53. 


LARGE  OBLIQUE  TEIAKGLE  OF  THE  ARM  A.^T>  CHEST. 

(Large  Triangular  ^^  Sling"  of  the  Arm.) 

Description. — A  piece  of  linen  or  flannel  folded  to  the  form  of 
a  triangle,  so  that  it  shall  have  a  base  of  some  sixty  inches,  and  a 
height  of  twenty-four. 

Application.- — Having  flexed  the  forearm  to  a  right  angle  with 

the  arm,  fold  it  to  the  breast ; 
place  the  base  of  the  triangle, 
A,  at  the  hand,  and  carry  one 
end  backwards  under  the  axilla 
of  the  diseased  member  to  bring 
forwards,  across  the  back,  to  the 
opposite  shoulder,  there  to  tie 
with  its  fellow,  b,  that  ascends 
directly  upwards  across  the 
front  part  of  the  chest  to  the 
same  side.  The  apex  of  the 
triangle,  c,  is  then  to  be  brought 
forward  and  pinned,  as  you  see 
in  the  wood-cut. 


Large  Oblique  Triangle  of  the  Ann  and 
the  Chest. 


MANUAL   OF  BANDAGING. 


69 


Uses. — To  support  the  arm  and  forearm  in  cases  of  injury. 
The  cut  represents  the  bandage  as  being  applied  over  the  naked 
body ;  it  is  applied  with  equal  frequency  over  the  clothmg. 


TEIANGULAR    FEONT    OF    THE    FOEEAEM. 

(TAe  Ordinary  Arm-Sling.) 

Description. — This  should  be  a  triangle  having  a  base  of 
forty-eight  inches,  and  a  height  of  twenty  inches.  The  laity  usually 
make  it  from  a  large  shawl  folded  to  a  wdde  cravat. 

Application. — Having  flexed  the  forearm  upon  the  arm,  fold  it 
FIG.  54.  to  the  chest,  and  place  the 

middle  of  the  base  of  the 
triangle  at  the  hand,  a,  and 
conduct  the  extremities  up 
and  around  the  neck,  and 
confine  them  by  tying.  The 
apex  of  the  triangle  can 
now  be  folded  under  the 
arm  to  a  sufficient  extent 
to  have  the  bandage  fit 
easily,  and  yet  furnish  efti- 
cient  support. 

Uses. — This,  in  some 
measure,  takes  the  place  of 
the  preceding,  yet  does  not 

Triangular  Front  of  the  Forearm.  ^  ,,  ,  .         ^ 

fully  supplant  it.  Is  used 
more  as  a  support  of  the  hand,  or  lower  part  of  the  forearm.  This 
bandage  may,  or  may  not,  be  applied  over  the  naked  bod}^ 


SMALL  FEONT  OF  THE  HAND  OE  FOEEAEM. 

(Small  Sling  of  the  Hand  or  Forearm.) 

Description. — A  rectangular  piece  of  cloth,   eighteen   inches 
long  by  nine  inches  wide. 
10 


70 


BANDAGES    OF   THE   UPPER  EXTREMITY. 


FIG.   55. 


Small  Front  of  the  Haud  or  Fore- 
arm. 


Application. — Flex  the 
forearm  at  right  angles  to 
the  arm,  and  fold  to  the 
chest.  Place  the  middle  of 
the  bandage  beneath  the  hand 
and  forearm,  carrying  both 
ends  upwards  and  pinning 
them  to  the  clothing  on  the 
breast. 

Uses. — As  a  support  ot 
the  hand  or  forearm  in  cases 
of  minor  injuries. 


POSTEEIOR  DOUBLE  FIGUl^E  OF  8  OF  THE  ELBOW  AND 
THE  OPPOSITE  AXILLA. 

Description. — This  bandage  should  be  a  cravat  two  yards  in 
length  by  eight  or  ten  inches  in  width.  It  can  be  made  out  of  a 
small  shawl,  if  necessary. 

Application. — Standing  in  front  of  your  patient,  and  holding 
FIG.  56.  the  bandage  with  its  centre 

across  the  palm  of  the 
hand,  place  the  centre  of 
the  cravat  over  the  elbow, 
A,  of  the  injured  member, 
both  ends  hanging  down 
towards  the  floor.  Seize 
the  innermost  extremity 
and  carry  it,  a,  across  the 
inside  of  the  arm,  under 
the  diseased  axilla,  up  in 
front  of  the  same  axilla  and 
over  the  same  shoulder, 
and  then  obliquely  down  across  the  back,  b,  to  the  opposite  axilla, 
where  you  surround  the  shoulder  with  the  same  extremity  of  the 
cravat,  at  last  entrusting  it  to  the  care  of  an  assistant.     Carry  the 


Posterior  Double  Figure  of  8  of  the  Elbow 
and  the  Opposite  Axilla. 


MANUAL    OF  BANDAOINO.  71 

other  extremity  of  the  cravat  forwards  across  the  bend  of  the  elbow, 
and  over  the  other  end  of  the  bandage,  then  backwards,  under 
the  diseased  axilla,  as  c,  and  then  finally  upwards  to  the  opposite 
shoulder,  there  confining  by  tying,  after  the  arm  has  been  sufficiently 
extended  backwards.  You  will  then  need  a  "  sling,"  for  the  hori- 
zontal support  of  the  forearm  and  hand,  which  can  be  pinned  to  the 
cravat  as  it  crosses  the  shoulder,  or  about  the  neck. 

Uses. — This  bandage  was  designed  by  Dr.  E.  M.  Moore  to 
take  the  place  of  the  numerous  dressings  for  fractured  clavicle.  It 
dispenses  with  the  "axillary  pad,"  and  the  more  complicated  system 
of  Fox  and  Desault,  and  seems,  from  certain  anatomical  reasons,  to 
be  superior  to  theirs  for  maintaining  a  coaptation  of  the  clavicular 
extremities.  It  .certainly  has  the  argument  of  simplicity  in  its 
favor. 


72 


BANDAGES    Of    THE   B0D7. 


CHAPTER    VIII. 


BANDAGES    OF    THE    BODY. 


SPIEAL    OF    THE    CHEST. 

Description.— This  bandage  should  be  nine  yards  in  length 
by  two  inches  in  width. 

Application. — Dropping  about  one  yard  of  the  bandage  ob- 
FiG,  57.  liquely   down    across    the 

chest  from  the  top  of  one 
of  the  shoulders,  the  left, 
for  instance,  carry  the  head 
of  the  bandage  down  the 
back  to  a  level  with  the 
arm-pits.  Make  now  the 
spiral  turns  2,  3,  4,  5,  6,  7, 
8,  and  9  about  the  chest, 
and  at  last  confine  by  pin- 
ning, as  at  10.  Carry,  now, 
the  free  end  of  the  band- 
age, II,  which  you  let  fall 
Spiral  of  the  Chest.  ^^  ^j^^  beginning  of  the  ap- 

plication, obliquely  up  over  the  chest  to  the  opposite  shoulder  from 
whence  dropped,  and  confine,  by  pinning,  to  the  posterior  spiral 
turns. 

Uses. — This  bandage  is  employed  where  compression  about 
the  chest  is  needed,  as  in  cases  of  fractures  of  the  ribs,  sternum  or 
vertebra,  or  separation  of  the  rib-cartilages.  Also  in  wounds  of  the 
abdomen  with  presentation  of  the  viscera.  It  is  also  of  use  in 
emphysema,  or  after  thoracico-paracentesis,  thus  compressing  the 
walls  of  the  chest,  if  they  be  much  expanded. 


MANUAL    OF  BANDAGING. 


73 


Variety.-  -If  the  roller-head  should  be  carried  down  to  the 
superior  margins  of  the  inferior  ribs,  and  then  the  circular  spirals 
made,  we  would  have  the  Spiral  of  the  Abdomen.  Full  a  yard  more 
of  bandage  is,  in  this  case,  required.  It  can  also  be  extended  down 
upon  the  abdomen,  from  the  "  Spiral  of  the  Chest,"  by  having  the 
bandage  as  long  again  as  needed  for  the  performance  of  the  chest 
spiral.  The  uses  of  these  varieties  are  similar  to  those  of  the  above. 
They  are  especially  applicable  where  abdominal  compression  is  de- 
sired, as  after  paracentesis  abdominis,  eviscerating  wounds,  drop- 
sies, ovarian  tumors,  etc. 


CIKCULAE-QUADRILATERAL    OF    THE    CHEST,   AND  DORSAL 
CERVICO-STERNAL  TRIANGLE. 

Description. — I.  There  should  be  a  quadrilateral  wide  enough 
to  cover  in  the  thoracic  region,  and  long  enough  to  encircle,  one 
or  more  times,  the  body,  and  may  or  may  not  be  of  several  thick- 
nesses. 

II.  A  triangle  having  a  base  one  yard  in  length,  and  a  height  of 
eighteen  inches. 

Application. — Encircle  the  body  with  the  quadrilateral  portion 
FIG.  58.  of  the  bandage,  as  a,  and 

confine  by  pins  or  stitches. 
This  done,  place  the  centre 
of  the  base  of  the  triangle 
at  the  nape  of  the  neck, 
carry  the  two  ends,  b,  b, 
forwards  and  downwards 
across  the  front  of  the  chest, 
and  confine  them  with  pins 
to  the  quadrilateral,  or 
thoracico  -  encircling  por- 
tion. Then  carry  the  apex 
of  the  triangle  down  the 
back,  and  pin  it  to  the 
quadrilateral  portion  ot  the 
bandage  at  the  back,  so  as  to  prevent  it  slipping  down. 


Circular-Quadrilateral  of  the  Chest,  and  Dorsal 
Cervico-Sternal  Triangle. 


74 


BANDAGES    OF   THE  BODY. 


Uses. — For  confining  dressings  to  any  portion  of  the  thoracic 
regions  ;  also  for  supporting  the  walls  of  the  chest,  in  case  of  injury 
or  disease,  where  the  respiratory  movements  are  to  be  confined. 

Variety. — -By  widening  the  quadrilateral  portion  of  the  band- 
age, A,  or  by  dropping  it  farther  down  the  body,  so  as  to  encircle  the 
abdomen,  we  get  the  Circular- Qiiadrilateral  of  the  Abdomen,  and  the 
Dorsal  Cervico-Sternal  Triangle;  or,  if  the  bandage  be  wide  enough 
to  cover  both  the  thoracic  and  abdominal  regions,  the  Circular- Quad- 
rilateral of  the  Abdomen  and  Thorax,  and  the  Dorsal  Cervico-Sternal 
Triangle.  In  either  of  the  cases  two  strips  should  be  passed  from  the 
anterior  surface  of  the  quadrilateral  to  its  posterior  surface,  across 
the  perinseum,  thus  preventing  the  bandage  from  slipping  upwards. 

The  7ises  of  these  bandages  are  to  furnish  support  to  the  ab- 
domen, as  well  as  the  thorax,  after  ovariotomy,  paracentesis  abdo- 
minis, or  other  injuries  of  the  abdominal  wall. 


ANTERIOR   THORACICO-SCAPULAR   TRIANGLE. 


Description. — This  bandage  should  be  made  of  a  triangle 
having  a  base  one  and  one-quarter  yards  in  length,  and  a  height  of 
eighteen  or  twenty  inches. 

Application. — Place  the  base  of  the  triangle,  a,  at  the  inferior 
Fi"-  59.  and  middle  portion  of  the  chest. 

Carry  the  two  ends,  b,  b,  hori- 
zontally about  the  body,  and  tie 
at  the  back.  Then  carry  the 
apex  of  the  triangle,  c,  up  across 
the  chest,  over  the  shoulder  dis- 
eased, and  then  down  to  the 
ends  tied  at  the  back,  where  it  is 
to  be  confined. 

Uses. — To  retain  dressings 

Anterior  Thoracico-Scapular  Triangle.  vi  t  .•,      ^  ^ 

upon  either  of  the  lateral-anterior 
surfaces,  or  the  anterior  surface,  of  the  chest. 

Variety. — By  placing  the  base  of  the  triangle  at  the  back,  and 
then  similarly  applying,    you  get  the  Posterior  Thoracico-Scapular 


MANUAL    OF  BANDAGING. 


75. 


Triangle,  which  is  useful  in  confining  dressings  to  either  the  posterior 
or  lateral  surfaces  of  the  thorax. 


FIGURE    OF   8    OF    THE    NECK    AND    AXILLA. 

(Spica  of  the  Shoulder.) 

Description. — This  bandage  should  be  made  from  a  roller,  six 
yards  in  length  by  two  inches  in  width. 

Application. — Place  the  initial  end  of  the  bandage  at  the  side 
FIG.  60.  of  the  neck,  i  ;  confine 

by  a  single  horizontal 
circular  turn,  2.  Continue 
the  course  of  the  band- 
age about  the  neck,  at 
last  crossing  down  to 
the  axilla  from  over  the 
back  of  the  shoulder, 
thus  finishing  course  3. 
Course  4  is  made  by 
carrying  the  roller-head 

Figure  of  8  of  the  Neck  and  Axilla.  , ,  ,      • 

up  over  the  anterior  sur- 
face of  the  shoulder,  from  under  the  axilla,  to  the  back  of  the  neck. 
Course  5  is  made  the  same  as  course  3 ;  course  6,  as  course  4 ; 
course  7,  as  course  5  ;  course  8,  as  course  6,  and  so  on.  At  last 
exhaust  the  bandage  by  a  single  horizontal  turn  about  the  neck,  and 
confine  as  usual. 

Uses.— To  confine  dressings  to  the  clavicular,  sub-clavicular, 
and  axillary  regions ;  also,  upon  the  shoulder. 


CRAVAT  OF  THE  NECK  AND  AXILLA. 

Description. — A  cravat  one  yard  in  length. 

Application. — Standing  at  the  side  of  your  patient,  place  the 
centre  of  the  cravat  beneath  the  diseased  axilla.  Carry,  now,  the 
posterior  extremity  up  over  the  scapular  region,  across  the  top  of  the 
shoulder,  and  around  over  the  front  of  the  neck  to  the  opposite  side, 
thus  imitating  course  7  of  the  preceding  bandage,  only  making  it  in 


76 


SAND  A  GES    OF   THE   BODY. 


the  opposite  direction ;  viz.,  upwards.  Then  carry  the  anterior 
extremity  up  over  the  front  of  the  diseased  axilla  and  shoulder  to  the 
back  of  the  neck  (imitating  course  8  of  the  preceding  bandage)  to 
tie  with  its  fellow  there. 

Uses. — Similar  to  those  for  which  The  Figure  of  8  of  the  Neck 
and  Axilla  is  employed. 


FIGUKE   OF  8  OF    THE    SHOULDER    AND    OPPOSITE  AXILLA. 

(Descending  Spica  of  the  Shoulder.) 

Description. — This  should  be  made  from  a  roller,  eight  yards 
in  length  by  two  inches  in  width. 

Application. — Place  the  initial  end  of  the  bandage  upon  the 
FIG.  61.  right  arm  (supposing 

it  to  be  the  right 
shoulder  that  you 
wish  to  cover)  and 
confine  it  by  two  hor- 
izontal circular  turns, 
2  and  3,  about  the 
arm.  Turn  4  make 
by  mounting  up  to 
tne  right  side  of  the 
neck  (from  the  back) 
and  passing  diagonal- 
Figure  of  S  of  the  Shoulder  and  Opposite  Axilla.  ^^  downwards  acrOSS 

the  chest  to  the  left  axilla.  Passing  under  this  axilla  remount  to  the 
right  side  of  the  neck  (across  the  back),  and  then  descend  to  the 
right  axilla,  thus  finishing  course  5.  Course  6,  is  similar  to  that  of 
course  4 ;  course  7,  to  that  of  course  5,  and  so  on  until  the  bandage 
is  exhausted,  at  last  confine  by  pinning. 

Uses. — Is  used  to  maintain  dressings  upon  the  shoulder,  or 
acromio-clavicular  region,  arm-pit,  or  axilla. 

Variety. — The  Ascending  Spica  of  she  Shoulder  is  applied  in  a 
very  similar  manner,  the  only  difference  being  that  course  4  takes 
the  place  of  course  14,  and  course  5  the  place  of  course  13,  etc.,  as 


MANUAL  OF  BANDAGING. 


77 


shown  in  the  cut ;  in  other  words,  you  ascend  gradually  upwards  to 
the  neck.  The  descending  variety  is  preferable,  as  it  gives  greater 
solidity. 


SIMPLE   BIAXILLAKY   CRAVAT. 

Description. — This  should  be  a  cravat  (a  triangle  folded  to 
this  form)  one  yard  in  length. 

Application. — Place  the  middle  of  the  cravat  in  front  of  the 
FIG.  62.  axilla  of  the  diseased 

side,  as  a  ;  carry  both 
extremities  upwards 
over  the  same  shoul- 
der as  B,  b',  there 
crossing  them.  Then 
conduct  the  extremi- 
ty that  passes  over 
the  front  of  the  axilla, 
B,  backwards  over  the 
shoulder  and  back,  to 
the  opposite  axilla, 
and  tie  to  the  other  extremity,  b',  that  has  been  passed  somewhat 
obliquely  across  the  breast,  as  at  c.  Afterwards  pin  one  to  the  other 
at  the  crossing-point,  d. 

Uses.- — To  confine  dressings  about  the  axillary  region  and 
shoulder,  also  for  bringing  the  shoulder  forwards  upon  the  chest  in 
cases  of  wounds  at  the  front  of  the  part,  or  of  burns  upon  the  poste- 
rior, or  scapular,  regions  where  vicious  cicatrization  may  be  feared. 


Simple  Biaxillary  Cravat. 


COMPOUND    BIAXILLARY   CRAVAT. 

Description. — -This  bandage  is  made  from  two  cravats,  each 
being  one  yard  in  length,  and  made  similarly  to  the  Simple  Bi- 
axillary. 

Application. — Placing  one  of  the  cravats,  the  centre,  beneath 
11 


78 


BANDAGES    OF   THE   BODY. 

FIG.   63. 


one  axilla,  the  right,  for  in- 
stance, conduct  the  two  ends 
upwards  and  tie  at  the 
shoulder,  as  a.  Place,  now, 
the  other  cravat,  beneath  the 
opposite  axilla,  carry  one 
extremity  forwards,  obliquely 
upwards  across  the  chest, 
and  the  other  obliquely  up- 
wards across  the  back,  to 
the  opposite  shoulder,  pas- 
sing one  end  through  the  noose  made  by  the  cravat,  a,  first  applied, 
and  confine  by  tying,  as  at  b. 

,   Uses. — Similar  to  the  above.     It  also  affords  means  for  confin- 
ing dressings  to  both  axillary  regions  simultaneously. 


Compound  Biaxillary  Cravat. 


CEOSS    OF    ONE    MAMMA. 

Description. — This  bandage  is  made  from  a  roller,  eight  yards 

in  length  by  two  inches  in  width. 

Application.- — Place  the  initial  end  of  the  bandage,  i,  below 
FIG.  64.  the  diseased  gland,  the  left  for 

example,  and  confine  by  a  hori- 
zontal circular  turn  about  the 
body,  2.  Continue  on  around 
the  body  till  you  come  to  a 
point  below  the  diseased  mam- 
ma, when  you  ascend  obliquely 
across  the  chest  to  the  opposite 
shoulder  (the  right  in  this  case) 
thus  finishing  course  3.  Course 
4  is  a  horizontal  circular  turn 
about  the  body,  in  line  of 
courses  i  and  2 ;  whilst  course  5 
is  similar  to  that  of  course  3. 
Continue  on  in  the  same  man- 
ner till  the  bandage  is  exhaust- 

ed,^when  you  confine  it  by  pinning,  as  usual. 


Cross  of  One  Mamma. 


MANUAL    OF  BANDAGING. 


79 


UseS.^As  a  "sling,"  or  support  for  an  inflamed  breast;  and 
also  for  exercising  a  compression  upon  the  gland,  when  occassion 
may  demand  it. 


TRIANGLE    OF    THE    MAMMA. 
Description. — This  should  be  made  from  a  triangle  having  a 
base  one  yard  in  length  and  a  height  of  eighteen  inches. 

Application. — Placing  the  base  of  the  triangle,  a,  at  the  xiphoid 
FIG.  65.  cartilage,  carry  one  end  oblique- 

ly up  over  the  opposite  shoulder, 
B,  and  the  other  end,  b',  below 
the  axilla  of  the  diseased  side, 
and  tie  them  together  at  the 
back.  The  apex  of  the  triangle, 
c,  is  then  to  be  carried  upwards 
over  the  shoulder  of  the  diseased 
side,  and  confined  to  the  extrem- 
ities of  the  triangle,  at  the  back. 


Triangle  of  the  Mamma. 


Uses. — Similar  to  the  preced- 
ing; but  it  is  more  especially 
adapted,  than  it,  for  retaining  cataplasms  and  other  dressings  to  the 
gland,  and  the  region  about  it.  Is  more  easily  applied  than  the 
above,  and  makes  an  excellent  suspensory  bandage  for  the  mamma. 


BOURSE  OF  THE  MAMMA. 
Description. — A  piece  of  lint,  ten  inches  in  length  and  eight 
inches  in  width  when  folded  at  the  centre.  Cut 
then  the  folded  comers  a  and  b  off  by  the 
dotted  lines  o-d,  and  e-f;  stitch,  then,  the 
whole  together  from  G  to  f  ;  viz.  g-o-d-e-f. 
This  done,  to  each  of  the  two  corners  at  o, 
and  the  two  at  h,  stitch  a  narrow  strip  suffi- 
ciently long  to  meet  and  tie,  with  its  fellow, 
(the  two  inferior)  about  the  body,  and  (the  two 
superior)  about  the  neck. 


80 


:B AND  AGES    Of   THE  SODY. 


Application. — Introduce  the  diseased  gland  into  the  bourse  a, 
FIG.  67.  carry  the  two  ends,  B  and  b',  around 

the  neck,  the  one  on  one  side,  and 
the  other  upon  the  other,  and  confine 
them  by  tying.  Conduct,  now,  the 
two  inferior  ends,  c  and  c',  hori- 
zontally about  the  chest,  and  tie 
them  either  there,  or,  after  crossing 
them,  bring  forwards  and  tie  in 
front. 

Uses. — As  a  suspensory  of  the 
gland  in  cases  of  hypertrophy,  or 
extreme  tiaccidit)-  of  the  thoracic  walls,  or  disease.  Also  useful  in 
confining  cataplasmata,  or  other  dressings. 


Bourse  of  Tlie  Mamma. 


CROSS    OF    THE    TWO    MAMMiE. 

Description. — This  bandage  should  be  made  from  a  roller, 
twelve  yards  in  length  by  two  inches  in  width. 

Application. — Place  the  initial  end  midway  between  the  lower 
FIG.  68  extremity  of  the  xiphoid  cartilage 

and  the  umbilicus,  and,  going 
from  right  to  left,  confine  it  by  a 
single  horizontal  turn,  2.  Continue 
on  in  the  same  course,  till  you 
come  to  the  right  side  of  the  chest 
when  you  mount  obliquely  up- 
wards across  the  chest  to  the  left 
shoulder,  thus  finishing  course  3. 
Course  4  is  a  horizontal  turn  about 
the  chest.  Continue  on  about  the 
body,  horizontally,  till  you  get  to 
the  left  scapular  region,  when  you  mount  obliquely  upwards  across 
the  back,  to  the  right  side  of  the  neck,  and  then  descend  obliquely 
downwards  across  the  front  of  the  chest,  below  the  left  mamma,  thus 
finishing  course  5.     Course  6  is  made  similarly  to  course  3  ;   course 


Cross  of  the  Two  Mammae. 


MANUAL   OP  BANDAGING. 


81 


7,  to  course  4 ;  course  8,  to  course  5  ;  course  9,  to  course  6  ;  course 
10,  to  course  7  ;  course  11,  to  course  8 ;  course  12,  to  course  9,  and 
so  on  until  the  roller  is  exhausted,  when  you  confine  as  usual. 

Uses. — In  case  of  disease  of  both  breasts  where  suspension  is 
required ;  also  for  compression,  and  for  retaining  of  dressings.  It  is 
not  a  very  stable  bandage,  besides  being  open  to  the  objection  of 
cording  the  neck  somewhat.  For  retaining  topical  dressings,  or  for 
suspension,  the  triangular  mammary  caps,  see  figure  65,  would  be 
preferable. 

Note. — Mayor's  system  may  be  used  in  making  this  bimammary 
bandage  by  simply  applying  the  Triangular  Caps  of  the  Mammae, 
one  to  each  gland ;  the  two  apices  being  confined  as  described  upon 
page  79,  or  else  tied  or  pinned  together.  This  would  then  be  known 
as  The  Biviammary  Triangle. 

Two  Bourses  may  also  be  employed ;  each  being  made  and 
applied  similarly  to  that  one  described  upon  pages  79  and  80. 


FIG.  96. 


POSTEEIOE    FIGUKE    OF  8    OF    THE    SHOULDEKS. 

(The  Posterior  ^^ Star"  Bandage  of  the  Old  Authors.) 

Description. — This  bandage  is  made  from  a  roller,  eight  yards 
in  length  by  two  inches  in  width. 

Application. — Place   the   initial  end,    i,  at   the   middle   and 

posterior  part  of  the  left 
arm.  Confine  it  by  two 
circular  turns  about  the 
arm,  2  and  3.  Continue  on 
in  the  same  course  till  you 
reach  the  anterior  surface 
of  the  arm,  when  you  as- 
cend obliquely  across  the 
axilla  and  chest  to  the  left 
side  of  the  neck  ;  from  here 
you  descend  obliquely 
across  the  back,  to  and 
beneath  the  right  axilla, thus 
finishing  course  4.     Carry 


Posterior  Figure  of  8  of  the  Stioulders. 


82 


BANDAGES    OF   THE  BODY. 


the  roller  under  this  axilla  up  to  the  top  of  the  same  shoulder,  and 
obliquely  down  across  the  back  to  the  left  axilla,  thus  finishing 
course  5.  Course  6  is  made  similarly  to  course  4 ;  course  7,  to 
course  5  ;  course  8,  to  course  6 ;  course  9,  to  course  7,  and  so  on 
until  the  bandage  is  exhausted,  when  you  confine  as  usual. 

Uses. — For  retaining  dressings  upon  either  the  anterior  or 
posterior  surface  of  the  chest ;  for  fixing  the  shoulders  backward  in 
case  of  burns  of  the  chest,  or  backward  displacement  of  the  sternal 
end  of  the  clavicle,  and  also  for  assisting  in  holding  in  coaptation  the 
ends  of  a  broken  clavicle,  or  clavicles.  Also  of  use  in  luxations  of 
the  acromial  end  of  the  clavicle.  It  is  necessary  to  have  consider- 
able cotton-wool,  or  some  like  substance,  in  the  axillae,  in  order  to 
guard  against  chafing  of  the  parts. 


SIMPLE   DORSAL   BIAXILLARY   CEAVAT. 

Description. — This  bandage  is  made  from  a  cravat  one  and 
one-half  yards  in  length. 

Application. — Place  the  middle  of  the  cravat  across  the  inter 
FIG.  70.  clavicular   space,    a.       Carry  one 

extremity  down  below  one  axilla, 
the  right  for  example,  and  up  over 
the  same  shoulder,  b.  Carry  the 
other  extremity  up  over  the  other 
shoulder,  b',  down  in  front  of  and 
beneath  the  same  axilla,  at  last 
confine  it  to  the  other  extremity, 
after  you  have  sufficiently  extended 
the  shoulders  backwards. 

Uses. — This  bandage  of  Mayor 

Simple  Dorsal  Biaxillary  Cravat.  ^^^^^    ^^^  ^^^^^  ^^  ^j^^    preceding, 

and  may  be  preferred  to  it  for  its  simplicity. 


COMPOUND  DORSAL  BIAXILLARY  CRAVAT. 

Description, — L    A  cravat  one  yard  in  length. 
IL    Another  cravat  two  feet  in  length. 


MANUAL    OF  BANDAGING. 


83 


Compound  Dorsal  Biaxillary  Cravat. 


Application. — Tie  the  shortest  cravat  about  one  of  the  shoul- 
FiG.  71.  ders,  the  left  for  example,  as  at  a. 

Now  place  the  center  of  the  other 
cravat  in  front  of  the  opposite 
axilla  (the  right  in  this  case),  and 
carry  one  end  up  over  the  same 
shoulder  (the  right)  and  the  other 
beneath  the  same  axilla,  to  the 
back.  Carry,  now,  the  superior 
extremity  through  the  noose  form- 
ed by  the  cravat  first  applied ;  then 
twist  the  other  extremity  about 
this  one,  as  at  b  and  c,  and  finally 
tie,  as  at  d. 

Uses. — The  same  as  the  Simple  Dorsal  Biaxillary  Cravat,  and 
the  Posterior  Figure  of  8  of  the  Shoulders.  This  is  a  very  powerful 
bandage,  and  the  arm-pits  need  to  be  well  padded. 

Variety. — Take  three  cravats,  two  of  them  being,  each,  about 
two  feet  in  length,  the  remaining  one  something  short  of  this.  Tie 
one  about  each  shoulder.  Then  tie  the  third  one  through  the  nooses 
formed  by  the  first  two,  so  as  to  bring  the  two  together  at  the  back, 
thus  taking  the  place  of  the  single  noose,  b,  c,  d,  of  the  preceding 
cut.  If  there  is  danger  of  either  of  these  bandages  slipping  from  the 
shoulder,  a  cravat  might  be  tied  across  the  breast,  from  one  to  the 
other,  similar  to  that  at  the  back,  thus  effectually  preventing  such  a 
mischance. 


ANTERIOE    FIGURE    OF  8    OF    THE    SHOULDERS. 

(Anterior  '■'■  Star^^  Bandage.^ 

Description. — This  bandage  should  be  eight  yards  in  length 
by  two  inches  in  width. 

Application.— Place  the   initial   end,   i,  at   the   front   of  the 


84 


BANDAGES    OF   THE  BODY. 


Anterior  Figure  of  8  of  the  Shoulders. 


PIG.  72.  middle    of    the    right 

arm,  and  confine  by 
two  horizontal  circular 
turns,  2  and  3.  Con- 
tinue on  in  the  same 
course,  till  you  reach 
the  posterior  surface  of 
the  arm,  when  you 
mount  up  over  the 
shoulder  of  the  same 
side  and  cross  diago- 
nally downwards  to  the 
left  axilla,  thus  finish- 
ing course  4.  Pass  the  roller-head  beneath  this  axilla,  and  over  the 
same  shoulder,  and  diagonally  down  across  the  front  of  the  chest  to 
the  right  axilla,  thus  finishing  course  5.  Conduct  the  bandage  under 
this  (the  right)  axilla,  and  then  upon  the  right  shoulder,  and  diago- 
nally down  across  the  front  of  the  breast  to  the  left  axilla,  thus  com- 
pleting course  6.  Course  7  is  made  similarly  to  course  5  ;  course  8, 
to  course  6  ;  course  9,  to  course  7,  and  so  on.  At  last  exhaust  the 
bandage,  and  confine  either  by  pinning  or  stitching. 

Uses. — ^In  cases  of  fractures  of  the  sternum,  or  separation  of 
the  sternal  cartilages ;  also  in  cases  of  bums  on  the  interscapular 
regions,  when  vicious  cicatrization  is  to  be  feared.  Might  be  of  use 
in  some  clavicular  dislocations.  As  in  all  of  the  axillary  bandages, 
this  one  needs  a  thorough  protection  of  the  axillae  by  cotton-wool  in 
order  to  prevent  chafing  of  the  parts,  especially  the  posterior  portion. 


SIMPLE    STERNAL    BIAXILLARY    CRAVAT. 

Description. — This  bandage  is  made  from  a  cravat  one  and 
one-half  yards  in  length. 

Application. — The  opposite  to  that  of  the  Dorsal  Cravat, 
described  upon  page  82,  this  one  being  appHed  across  the  chest. 

Uses. — Similar  to  those  for  which  the  preceding  is  employed. 


MANUAL  OF  BANDAGING.  85 

COMPOUND    STERNAL    BIAXILARY    CRAVAT. 

Description. — Two  cravats,  one  one  yard  m  length,  the  other 
two  feet  in  length. 

Application. — Opposite  to  that  of  the  Compound  Dorsal 
Biaxillary  Cravat,  described  upon  page  83.  This  one  being  applied 
across  the  chest. 

Uses. — Same  as  the  Anterior  Figure  of  8  of  the  Shoulders. 

Variety. — Prepare  three  cravats,  two  of  them  being  two  feet  in 
length,  the  third  one  not  quite  so  long.  After  tying  one  of  the  two- 
feet  ones  about  each  shoulder,  tie  the  remaining  one  into  the  nooses 
formed  by  the  other  two,  across  the  front  of  the  chest.  A  fourth 
cravat  is  now  necessary  to  prevent  those  fastened  about  the  shoulders 
from  slipping  forwards  and  off  these  parts,  and  is  tied  to  them  across 
the  back. 


12 


86  BANDAGES  OF   THE   LOWER    EXTREMITY. 


CHAPTER    IX. 
BANDAGES   OF    THE    LOWER    EXTREMITY. 

SPIRAL  OF  ONE  TOE. 

Description. — This  should  be  made  from  a  roller  four  feet 
in  length  by  three-quarters  of  an  inch  in  width. 

Application. — This  is  so  similar  to  that  of  the  Spiral  of  One 
Finger,  described  upon  page  54,  tigure  39.  that  no  further  discussion 
is  necessary. 

Uses. — For  injuries  of  the  toes,  similar  to  those  of  the  fingers 
for  which  the  spiral  is  there  used. 

FIGURE  OF    8    OF    ONE    TOE. 

(Spica  of  the  Toe.) 

Description. — This  bandage  should  be  made  from  a  roller, 
two  yards  in  length  by  three-quarters  of  an  inch  in  width. 

Application. — Similar  to  that  of  the  Figure  of  8  of  the  I'humb 
and  Wrist,  or  Spica  of  the  Thumb.     See  figure  40,  page  55. 

Uses. — Of  a  similar  use  to  that  of  the  Spica  of  the  Thumb. 

DOUBLE    T    OF    THE    TOES    AND    ANKLE. 
Description,  Application  and  Uses  are  so  similar  to  the  Double 
T  of  the  Back  of  the  Hand  and  Wrist,  that  a  reference  to  it,  figures 
42  and  43,  pages  57  and  58,  will  be   sufiicient  for  its  application  to 
the  foot. 

SPIRAL    OF    ALL   THE    TOES. 
(Gauntlet  oj  the  Foot.) 
Description, — This  bandage  should  be  ten  yards  in  length  by 
three-quarters  of  an  inch  in  width. 


MANUAL    OF  BANDAGING. 


37 


Application. — Similar  to  the  Gauntlet  of  the  Hand.  See  figure 
47,  page  6i. 

Uses. — Similar  to  those  of  the  Spiral  of  All  the  Fingers,  just 
referred  to,  only  in  case  of  diseases  or  injuries  of  the  foot. 


FIGURE  OF  8  OF    THE    FOOT   AND   ANKLE. 

Description. — This  should  be  a  roller  two  and  a  half  yards  in 

length  by  one  and  three-quarter  inches  in  width. 

Application. — Place  the  initial  end,  i,  at  the  front  of  the  leg, 
FIG.  73.  a  few  fingers'  breadth  above  the  ankle, 

and  confine  it  by  the  horizontal  circular 
turn,  2.  Continue  on  in  the  same  course 
till  you  come  to  the  inner  malleolus 
again,  supposing  it  to  be  the  left  foot 
that  you  are  dressing,  when  you  descend 
obliquely  across  the  dorsum  of  the  foot 
to  the  fifth  metatarsus,  thus  completing 
course  3.  Make,  then,  a  circular  turn 
about  the  metatarsal  bones  (course  4), 
coming  obliquely  across  the  dorsum  of 
the  foot,  from  within  outwards,  to  the 
outer  malleolus,  thus  completing  course 
5.  Course  6  is  made  similarly  to  course 
3,  course  7  to  course  5,  and  so  on.  At 
last    exhaust    the   bandage   by   circular 

turns  about  the  lower  portion  of  the  leg,  and  confine  in  the  ordinary 

way. 

Uses. — For  confining  dressings   either  to  the  dorsum  of  the 

foot,  or  to  the  surface  contiguous  to  the  malleoli.     Also  for  com 

pression,  after  venesection  from  one  of  the  dorsal  veins  of  the  foot ; 

a  graduated  compress  would  be  necessary  in  this  case, 

SPIRAL    OF    THE    FOOT. 
This  bandage  is  but  a  part  of  the  Spiral  of  the  Inferior  Extremi- 
ty, and  will  be  sufficiently  described  when  we  come  to  treat  of  that 
dressing. 


Figure  of  8  of  the  Foot  and 
Ankle. 


8S  BANDAGES    OF   THE  LOWER  EXTREMITY. 

TRIANGLE    OF    THE    FOOT. 
Description. — A  triangle  vaXh  a  base  two  feet  in  length  and  a 
height  of  ten  inches. 

Application. — Place  the  base  of  the  triangle  obhquely  across 
FIG.  74.  the  front  of  the   ankle,  a,  and  carry  the 

superior  end,  b,  around  the  lower  part  of 
the  leg,  and  confine.  Conduct  the  in- 
ferior extremity  about  the  metatarso- 
phalangeal bones  and  pin,  as  at  c'.  Then 
conduct  the  apex  of  the  bandage  about 
the  heel,  and  pin  as  at  c. 

Uses. — To  confine  dressings  either  to 
the  dorsum  or  the  sole  of  the  foot,  to 
either  of  the  malleoli,  or  regions  adjacent, 
or  to  the  calcanean  region,  or  the  lower 
part  of  the  leg. 


Triangle  of  the  Foot. 


FOUE-TAILED    BANDAGE  OF  THE  INSTEP. 
(Sling  of  the  Instep.) 

Description. — This  should  be  a  strip  of  cloth,  eighteen  inches 
in  length,  and  four  inches,  or  more,  in  width,  cut  to  a  four-tailed 
bandage,  as  seen  in  the  compress  of  four  heads  (figure  4). 

Application. — Place  the  centre  of  the  bandage  at  the  instep, 
and  carry  the  two  superior  ends  around  the  lower  part  of  the  leg 
and  tie  them ;  then  carry  the  two  inferior  ends  around  the  tarsal 
portion  of  the  foot,  and  tie  also. 

Uses. — To  confine  cataplasmata,  and  other  dressings,  to  the 
instep,  lower  front  portion  of  the  leg,  and  the  tarsus. 


FOUE-TAILED    BANDAGE    OF    THE    HEEL. 
(Sling  of  the  Heel.) 

Description. — This  should   be  eighteen  inches  in  length  and 
four  or  more  in  width,  and  torn  to  a  four-tailed  bandage. 

Application. — Place  the  body  of  the  bandage  at  the  heel  and 


MANUAL   OF  BAKDAGIKG. 


89 


carry  the  two  superior  ends  around  the  lower  portion  of  the  leg,  and 
confine.  The  two  inferior  ends  are  then  to  be  carried  about  the 
tarsus,  and  also  tied. 

Uses. — ^.To  confine  dressings  to  the  calcanean  region. 


SHEATH    OF    THE    FOOT. 
Instead   of  the   more   elaborate   bandage   proposed    by   some 
surgeons,    an    equally    efficacious   bandage,    and    certainly    easier 
obtained,    is   a   common    '■'■  stockingr      Is    used   as   a    retainer   of 
cataplasmata  to  the  toes  or  foot. 


POSTERIOR    FIGURE    OF    8    OF    THE    KNEE, 
Description. — ^The  roller  should  be  four  yards  in  length  by 

one  and  three-quarter  inches  in  width. 

FIG.  75.  Application. — Placing   the  initial   end 

of  the  bandage,  i,  at  a  point  somewhat 
above  the  popliteal  space,  confine  it  by 
a  horizontal  turn  of  the  bandage,  2.  Con- 
tinue on  in  the  same  direction,  passing 
over  the  front  of  the  thigh,  till  you  come 
nearly  to  the  posterior  surface  again,  where 
you  descend,  obliquely,  across  the  popliteal 
space  to  the  opposite  border,  thus  finishing 
course  3.  Course  4  is  a  horizontal  turn 
about  the  upper  part  of  the  leg;  while 
course  5  ascends  obliquely  across  the  pop- 
liteal space  to  the  opposite  lateral  border. 

Course  6  is  in  line  of  course  3  ;  course  7,  of  course  5,  and   so   on. 

Having  exhausted  the  bandage,  after  covering  in  the  popliteal  space 

confine  in  the  ordinary  way. 

Uses.- -To  confine  dressings  to  the  popliteal  space;    or,  with 

the  aid  of  a  graduated  compress,  to  exercise  compression  upon  an 

aneurism  at  this  point. 


Posterior  Figure  of  8  of 
the  Knee. 


90 


BANDAGES   OF  THE  LOWER  EXTREMITY 


FIG.   76. 


THE    POPLITEAL    CRAVAT. 

Description. — A  cravat  some  four  feet  in  length. 

Application, — Place  the  centre  of  the  cravat,  a,  at  a  point  just 
above  the  popliteal  space,  and  carry  the  two 
ends  horizontally  forwards  about  the  thigh  ; 
cross  them,  and  descend  obliquely  across  the 
space,  B,  b',  crossing  one  above  the  other 
there ;  carry  them  now  horizontally  forwards 
about  the  upper  portion  of  the  leg,  crossing 
them  below  the  patella,  to  conduct  them  to 
the  posterior  surface  of  the  leg,  confining  by 
tying,  as  at  c. 

Uses. — This  bandage  fulfils  the  same  in- 
dications as  the  above. 


The  Popliteal  Cravat. 


ANTEEIOE    FIGURE    OF    8    OF    THE    KNEE. 

Description. — A  roller,  four  yards  in  length  by  one  and  three- 
quarter  inches  in  width. 

Application. — Essentially  the  same  as  that  of  the  Posterior 
Figure  of  8  described  upon  page  89,  only  remembering  that  it  is  to 
the  anterior  surface  of  the  limb  that  you  are  applying  the  bandage. 

Uses. — To  aid  in  supporting  the  patella,  when  fractured ;  to 
compress  an  eftusion  into  the  joint,  and  confine  various  dressings 
thereon. 


CRAVAT    OF    THE    KNEE. 

Description. — A  cravat  some  four  feet  in  length. 

Application. — Place  the  centre  of  the  cravat,  A,  see  figure 
76,  page  90,  above  the  patella,  and  carry  the  two  extremities  back- 
wards and  cross  them,  and  so  bring  diagonally  down  across  the  front 
of  the  patella,  in  a  measure  similar  to  that  seen  in  The  Popliteal 
Cravat  just  referred  to.  The  other  courses  of  the  bandage  are  made 
similarly  to  the  corresponding  courses  of  this  popliteal  dressing. 

Uses. — As  an  approximator  of  the  fragments  of  a  fractured 
patella,  and  for  "  steadying "  the  motions  of  the  joint,  or  confining 
loose  dressings  thereon. 


MANUAL   OF  BANDAGING. 


91 


TESTUDO    OF     THE    KNEE. 


(Roller  Cap  of  the  Knee.) 


FIG.   77. 


Description. — A  roller  eight  feet  in  length  by  one  and  three- 
quarter  inches  in  width. 

Application. — -Place  the  initial  end  of  the  bandage,  i,  below 
the  patella,  and  confine  by  a  single  circu- 
lar turn,  2.  Continue  on  in  the  same 
course  with  the  bandage,  making  an  as- 
cending spiral  course  for  turn  3.  The  rol- 
ler-head is  now  carried  upwards  across 
the  popliteal  space,  above  the  femuric 
condyles,  and  made  to  take  the  descend- 
ing spiral  course  4,  to  finish  this  turn  of 
the  bandage.  It  is  then  carried  down- 
wards across  the  popliteal  space,  so  as  to 
be  in  readiness  to  make  the  ascending 
spiral  course  5.  Course  6  is  made  simi- 
larly to  course  4 ;  course  7,  to  course  5, 
and  so  on,  gradually  "  drawing  in  "  the  bandage  till  the  patella  is 
entirely  covered,  when  you  either  confine,  or  else  go  on  to  finish  the 
bandage  as  a  spiral  of  the  thigh. 

Uses. — To  confine  dressings  about  the  knee-joint,  to  exercise 
compression  thereon  in  cases  of  synovitis,  or  to  steady  the  joint  and 
prevent  motion  in  cases  of  other  injuries  of  the  leg.  Is  frequently 
made  use  of  in  the  Spiral  of  the  Inferior  Extremity  when  covering 
in  the  knee-joint. 

Variety. — Instead  of  the  alternate  upward  and  downward  spiral 
courses  being  used,  a  bandage,  fulfilling  the  indications  of  the  above, 
may  be  made  by  the  use  of  continued  ascending  spirals  about  the 
member.  This  is  the  form  most  generally  made  use  of  in  applying 
the  Spiral  of  the  Inferior  Extremity,  and  is  seen  in  the  figure  of 
that  bandage  on  a  following  page.  It  is  known  as  The  Spiral  of  the 
Knee. 


Testudo  of  the  Knee. 


92  BANDAGES    OF   THE   LOWER    EXTREMITY. 

FOUR-TAILED    BANDAGE    OF    THE    KNEE. 

Description. — A  strip  of  linen  or  cotton,  from  eight  to  ten 
inches  in  width,  and  one  yard  in  length.  Each  end  to  be  torn  back 
(at  its  centre)  to  within  eight  inches  of  the  middle  of  the  bandage. 

^^^-  '^-  Application. — Place  the  plane  of  the 

bandage,  a,  over  the  patella,  and  carry  the 
superior  ends  of  the  bandage  around  the 
lower  part  of  the  thigh,  crossing  them  to 
remount  the  member,  b,  to  tie  in  front.  Then 
conduct  the  two  inferior  extremities  in  a 
similar  manner  about  the  upper  portion  of 
the  leg,  D,  to  finally  confine  by  tying  below 
the  patella. 

Uses. — To  confine  cataplasmata  or 
vesicants  upon  the  patellar  region.  It  can 
also  be  made  use  of  to  approximate  the 
patellar  fragments,  when  the  bone  is  frac- 
tured, or,  with  the  aid  of  compresses,  to  exercise  compression,  in 
cases  of  chronic  synovitis. 


Four-tailed  Bandage  of 
the  Knee. 


SIMPLE    SPIRAL    OF    THE    LEG. 

Description. — This  bandage  is  made  from  a  roller  four  yards 
in  length  by  two  inches  in  width. 

Application. — Beginning  at  the  ankle,  make  a  simple  circular 
turn  about  the  member,  thus  confining  the  initial  end  of  the  band- 
age. Then  continue  the  turns  of  the  bandage  spirally  about  the 
member  (omitting  the  reverses)  as  seen  in  turns  15,  16  and  17  of 
the  figure  accompanying  the  Spiral  of  the  Inferior  Extremity.  At 
last  confine  as  usual. 

Uses. — For  maintaining  pressure  upon  the  parts  covered,  or  for 
retaining  dressings  thereon.  Is  not  a  very  stable  bandage  should 
the  musculi  gastrocnemius  et  soleus  be  well  developed. 

Variety. — This  bandage  may  be  applied  to  the  thigh ;  it  then 
becomes  T/ie  Simple  Spiral  of  the  Thigh.  The  starting  point,  in  this 
case,  being  at  the  knee. 


MANUAL    OF  BANDAGING. 


93 


KEVERSED    SPIRAL    OF    THE    LEG. 

Description. — A  roller  eight  feet  in  length  by  two  inches  in 
width. 

Application. — This  is  but  a  part  of  the  bandage  described 
under  the  head  of  The  Reversed  Spiral  of  the  Inferior  Extremity,  and 
will  be  sufficiently  described  when  treating  of  that  bandage.  See 
figure  on  page  96. 

Uses. — This  makes  a  very  stable  sort  of  dressing,  and  is  to  be 
employed,  in  most  cases,  in  preference  to  the  preceding  bandage, 
as  it  is  not  so  liable  to  slip  down  and  out  of  place. 

Variety. — This  bandage  may  be  equally  well  applied  upon  the 
thigh,  starting  at  the  knee.  It  is  then  known  as  7//e  Reversed  Spiral 
of  the  J  high. 


THE  FIGURE  OF  8  SPIRAL  OF  THE  EXTREMITIES. 

Description.- -This  bandage  is  a //(S//^^/^  spiral,  and  needs  for 
its  application  a  roller  bandage  ten  yards  in  length  by  two  inches  in 
width. 

Application.-  Place  the  initial  end  at  the  roots  of  the  toes, 
confining  by  a  single  spiral  turn  about 
the  foot,  and  cover  the  foot  as  in  the 
Spiral  of  the  Inferior  Extremity,  by  rever- 
ses and  figures-of-8.  Having  reached  the 
leg,  one  turn  and  a  half  is  made  before  a 
reverse  is  used.  Thus  the  reverse  is 
employed  on  the  second  turn  of  an  ordi- 
nary spiral  instead  of  upon  the  first,  as  in 
the  simple  spiral  with  reverses.  This 
process  of  reversing  upon  each  second 
turn  from  the  last  reversement  is  pursued 
up  the  entire  limb.  Hence,  course  9  is 
a  simple  spiral,  whilst  course  10  is  a 
spiral  with  a  reverse.  Course  1 1  is  com- 
pleted as  an  upward  spiral  about  the  limb,  «vith  no  reverse,  whilst 
13 


The  Figure  of  8  Spiral  of  the 
Extremities. 


94 


BANDAGES  OF  THE  LOWER  EXTREMITY 


course  12  would  be  a  reversed  spiral,  coming  from  above  doAvn- 
wards,  across  the  front  of  the  limb.  Course  13  is  similar  to  course 
II  ;  course  14,  to  course  12,  and  so  on  until  the  bandage  is  exhaust- 
ed. This  makes,  then,  a  Figure  of  8  Spiral  of  the  Extremities  with 
alternate  reverses. 

Uses. — Similar  to  those  for  which  the  Simple  and  the  Reversed 
Spirals  are  employed,  and  may  be  used  on  either  the  upper  or  lower 
extremity.  It  makes  a  very  secure  method  of  dressing,  and  gains 
this  advantage  through  this  fact :  that  the  superficial  courses  (the 
reversed  ones)  rest  upon  cloth,  and  not  upon  the  slippery  integument, 
as  in  the  case  of  the  other  bandages.  The  same  advantage  might 
be  gained  by  covering  an  ordinary  spiral  with  a  second  bandage, — 
an  ordinary  Reversed  Spiral. 

This  variety  of  the  spiral  bandages  is  especially  useful  in  plaster- 
of-Paris,  starch,  or  other  so-called  immovable  dressings ;  also  in 
fractures,  or  other  cases  where  extension  is  demanded,  and  where  a 
long  interim  between  dressings  is  desirable. 

Variety. — If  the  bandage  is  composed  of  very  extensible  mate- 
FiG.  80  rial,  as  very  thinly  woven  flannel,  so  as  to 

be  easily  "moulded  to  a  part,"  it  may 
be  made  throughout  luithout  a  single 
rei'erse.  Each  course  of  the  bandage 
would  then  be  a  single  figure  of  8  about 
the  limb  ;  thus,  turns  7  and  8  would  be 
simple  circles  of  the  limb ;  turn  9,  an 
upivard  spiral,  turn  i  o,  a  downward  spiral 
turn  II,  an  upward  spiral  again,  overlap- 
ping turn  9  ;  turn  12,  a  downward  spiral, 
overlapping  turn  10,  and  so  on  until  the 
limb  is  sufficiently  encompassed. 

This  also  makes  quite  a  firm  dressing, 
as  the  superficial  courses  of  the  bandage  rest  upon  flannel,  and  not 
upon  the  integument.  It  is  used  in  cases  similar  to  the  preceding. 
It  is  known  2,?,  iht  Figure  of  8  Batidage  of  the  Extremities^  and  can 
be  applied,  as  its  name  indicates,  to  either  the  inferior  or  superior, 
extremities. 


Figure  of  8  Bandage  of  the 
Extremities. 


MANUAL    OF  BANDAGING. 


95 


FIG.   81. 


TRIANGLE   OF   THE   LEG. 

Description. — A  triangle  one  yard  in  length  at  the  base,  and 
eighteen  inches  in  height. 

Application. — Place  the  base  of  the  triangle,  a,  obhquely 
across  the  front  of  the  leg,  and  carry  the 
superior  extremity  around  below  the  patella, 
and  confine  with  a  pin,  b.  Then  conduct 
the  inferior  extremity  around  the  lower  part 
of  the  leg,  and  also  confine  it,  c.  Then 
carry  the  apex  of  the  triangle  around  the 
"calf"  of  the  leg,  also  confining  it  with  a 
pin,  as  at  d. 

Uses. — Useful  in  confining  dressings  to 
the  parts  it  covers,  and  also  for  maintaining 
compression,  when  this  may  be  required. 

Variety. — This   bandage  may   be    ap- 

Triangle  of  the  Leg.  ^^-^^   ^^  ^^^  p^^.^  ^^  ^^^   j^^^  ^^  ^^^^  ^^  ^^^ 

arm  and  forearm,  fulfilling  similar  indications  in  diseases  or  injuries 
of  those  parts. 


FOUR-TAILED    BANDAGE    OF    THE    LEG. 

Description. — A  piece  of  cloth  wide  enough  to  sufiiciently 
cover  the  diseased  portion  of  the  member.  This  is  then  to  be  cut 
back,  at  the  ends,  to  near  its  centre,  as  you  see  in  the  compress 
(figure  4),  upon  page  17. 

Application.^ — -The  plane  of  the  bandage  is  to  be  placed  over 
the  calf  of  the  leg,  and  the  two  superior  ends  carried  forwards,  and 
around  the  leg,  below  the  patella,  and  confined.  The  two  inferior 
ends  are  then  to  be  conducted  about  the  lower  portion  ot  the  leg, 
and  also  confined  by  tying, 

Uses. — To  confine  cataplasmata,  or  other  dressings,  upon  the 
gastrocnemial  and  soleal  region, 


96 


BANDAGES    OF   THE   LOWER    EXTREMITY. 


EEVERSED  SPIRAL  OF  THE   INFEEIOR   EXTREMITY. 


Description. — This  bandage  is  made   from  a  roller  eighteen 
yards  in  length  by  two  inches  in  width. 

Application. — Place  the  initial  end  of  the  bandage  at  the 
metatarso-phalangeal  articulation,  and  confine 
by  two  circular  turns  about  the  foot  at  this 
point.  Continue  on  about  the  foot  in  the  same 
manner,  only  making  a  reverse  at  each  course 
of  the  bandage,  until  the  ankle  is  reached,  as 
you  see  in  the  wood-cut.  Or,  it  is  sometimes 
best  to  make  the  last  two  or  three  turns  about 
the  foot  and  ankle  in  figure-of-8's,  as  you  see 
in  wood-cut  number  73,  page  87.  It  is  also 
often  necessary  to  fill  up  the  hollows  about  the 
ankles  with  cotton-wool.  Having  got  so  far 
in  the  application  of  the  bandage,  make  three 
or  four  spiral  turns  about  the  lower  part  of  the 
leg,  courses  15,  16,  17,  18  in  the  figure,  before 
you  begin  the  reverses  about  the  leg, — courses 
19  to  30  inclusive;  you  then  come  to  the 
knee,  which  may  be  covered  in  by  The  Testudo, 
figure  77,  page  91,  or  the  simple  spiral  turns, 
3t,  32,  ?,?>,  34  and  35  in  the  cut.  Having 
cleared  the  femuric  condyles,  you  then  make  spiral  reverses  to  the 
hip,  where  you  confine  the  bandage  in  the  usual  way. 

Uses. — ^For  all  the  multitudinous  purposes  such  an  injured  or 
diseased  member  may  demand.  The  same  caution  should  be  observed 
here  as  was  spoken  of  under  the  Reversed  Spiral  of  the  Superior 
Extremity,  page  65. 


Keversed  Spiral  of  the 
Inferior  Extremity. 


RECURRENT  FOR  AMPUTATED  THIGH. 


Description. — This  bandage  should  be  twelve  yards  in  length 
by  one  and  three-quarter  inches  in  width. 


MANUAL    OF  BANDAGING. 


97 


Application.- 

FIG.    83. 


-Place  the  initial  end,  i,  upon  the  front  of  the 
thigh,  and   confine  by  three    horizontal 


circular  turns, 


and  4.     Continue  the 


Recurrent  for  Amputated  Thigh. 


course  of  the  bandage  about  the  limb, 
horizontally,  finishing  turn  5  at  the  lateral 
border  of  the  member.  Reverse  the 
bandage  at  ri^/ii  angles,  and  continue 
course  6  down  the  limb,  across  the 
stump,  then  up  to  the  fourth  course  of 
the  bandage,  thus  finishing  turn.  6.  Re- 
verse, now,  the  bandage  at  right  angles 
again,  and  encircle  the  member  for  turn 
7,  finishing  it,  anteriorly,  at  the  middle 
of  the  limb,  as  course  8.  Continue  the 
bandage  on  in  the  same  course  to  finish 
turn  9  upon  the  member's  anterior  surface.  Again  you  reverse  at 
right  angles,  and  carry  the  bandage  longitudinally  down  the  limb 
and  across  the  stump,  thus  making  the  tenth  course  of  the  bandage. 
The  remaining  courses  of  the  bandage  are  applied  similarly  to  those 
just  described.  At  last,  when  the  stump  is  covered,  and  the  band- 
age exhausted,  confine  in  the  usual  way,  by  pinning. 

Uses. — For  confining  dressings  to  a  "  stump."  Is  somewhat 
"  tedious  "  of  application,  and  hence  the  two  following  bandages  are 
to  be  preferred  to  it. 

Variety. — This  bandage  is  equally  applicable  for  any  stump  of 
the  leg,  or  of  the  upper  extremity.  It  would  then  be  of  the  same 
width,  but  somewhat  shorter.  It  would  then  be  known  (from  its 
respective  uses)  as  The  Recurrent  for  an  Amputated  Leg;  2  he  Recur- 
rent for  an  Amputated  Forearm ;  The  Recurrent  for  an  Amputated 
Arm.  A  somewhat  similar  Recurrent  has  been  devised  for  a  hip- 
joint  stump,  and  also  for  a  shoulder-joint  stump.  The  same  objec- 
tion holds  good  against  these  bandages,  as  the  one  just  described  ; 
viz.:  rather  more  ornate  than  useful. 


98 


BANDAGES    OF    THE  LOWER  EXTREMITY. 


TKI ANGLE    FOE    THIGH    STUMP. 

Description. — This  should  be  a  triangle  having  a  base  one 
yard  in  length,  and  a  height  of  eighteen  inches. 

Application. — Place  the  middle  of  the  base  of  the  triangle,  A, 
Fio-  84.  upon  the  anterior  surface  of   the  thigh, 

at  a  proper  distance  from  the  cut  sur- 
face ;  carry  the  two  extremities  back- 
wards about  the  member,  and  bring  them 
forwards,  after  crossing  them,  to  pin  at 
the  front,  b  and  c.  Carry,  then,  the  apex 
of  the  triangle  directly  across  the  stump 
and  up  the  posterior  surface  of  the  limb, 
pinning  to  the  crossed  extremities  b  and  c. 
Uses. — This  is  a  very  convenient 
bandage  for  protecting  a  stump  from  in- 
jury from  clothing  and  the  like,  and  also  for  confining  cataplasmata. 
Variety. — -By  varying  the  size  of  the  triangle,  it  can  be  made 
to  answer  for  any  stump  of  either  the  upper  or  lower  extremity.  It 
would  then  be  known  as  The  Triangle  for  Leg  Stump,  The  Triangle 
for  Arm  Stump,  etc.,  according  to  the  part  upon  which  it  might  be 
applied. 


Triangle  for  Thigh  Stmiip. 


MALTESE-CEOSS   FOE   THIGH   STUMP. 

Description. — I.    A   piece  of    lint,    or  cloth,   sixteen  inches 
square,  cut  to  the  form  of  a   Maltese  cross,  see  figure  7,  page  20. 
II.  A  roller  two  yards  in  length,  by  two  inches  in  width. 

FIG.  85.  Application. — Place  the  centre  of  the 

cross.  A,  over  the  centre  of  the  stump, 
and  fold  the  edges  over  each  other,  b 
and  c,  as  you  see  in  the  wood-cut,  so 
that  they  may  lie  as  smoothly  as  pos- 
sible. Then  confine  with  the  roller  by 
the  use  of  circular  turns  about  the  limb, 
using  reverses,  if  need  be. 

Uses. — Similar  to  the  Stump-triangle, 
Maltese-cross  for  Thigh  Stump,     ^^^j  equally  useful  and  easy  of  application. 


MANUAL  OF  BANDAGING. 


99 


Variety. — By  varying  the  size  of  the  cross,  and  the  roller, 
this  bandage  is  equally  applicable  for  any  stump  of  either  extremity. 
It  makes  most  an  excellent  dressing  for  hip  or  shoulder-joint 
stumps.  It  would  then  be  TAe  Maltese-cross  for  Leg  Stumps  The 
Maltese-cross  for  Arm  Stump.,  etc.,  according  to  the  uses  for  which 
it  is  employed. 


CAPUTINA. 

(Rosette  Stump  Dressing.) 

Description. — Take  from  nine  to  fifteen  strips  of  cloth 
(according  to  the  size  of  the  stump),  having  each  one  one  and  three- 
quarter  inches  in  width,  by  two  and  a-half  feet  in  length. 

FIG.  86.  These    strips    are     to    be 

placed  in  two  groups.  One 
set  should  be  so  arranged  as 
to  form  a  half  rosette,  a, 
whilst  the  others  should  be  ar- 
ranged in  a  parallel  group, 
B,  each  strip  slightly  overlap- 
ping its  fellow.  The  half- 
rosette,  including  one  strip 
parallel  with  the  second  set, 
is  made  secure  with  a  pin,  or 
stitches,  at  the  point  of  radi- 
ation of  the  different  pieces, 
called  its  center,  as  a.  The 
horizontal  strips  of  parallels 
may  now  be  stitched  together 
at  their  centers,  though  this 
is  not  necessary.  The  whole 
bandage  is  then  spread  upon  a  newspaper.  The  horizontal  strip,  c, 
of  the  rosette  is  laid  upon  the  first  piece  of  the  parallel  strips  (so 
that  the  set  of  parallels  becomes  but  an  extension  of  the  rosette), 


Diagram  of  the  Caputina. 


100 


BANDAGES    OF   THE   LOWER    EXTREMITY. 


and  fastened  to  it.     The  object  of  spreading  it  upon  the  paper  is 
only  for  convenience  in  carrying  and  handling. 

Application. — The  stump  is  now  made  ready  for  this  final 
FIG-  87.  bandage.     The  centre,  a,   figure  86,  is 

placed  opposite  the  median  line  of  the 
under  surface  of  the  stump,  at  a  point 
some  six  inches  from  its  end,  and  con- 
fined there  by  the  long  cross  strip,  c- 
c,  which  encircles  the  member.  The 
remaining  portions  of  the  rosette  are 
thenla  id,  smoothly  and  successively, 
over  the  stump,  covering  the  end  com- 
pletely. The  bandage  is  then  finished 
by  passing  the  horizontal  parallel  strips, 
B,  over  the  remaining  portion  of  the 
limb,  securing  the  free  ends  of  the  ro- 
sette that  are  folded  over  its  anterior 
surface,  thus  completing  the  dressing 
which  is  represented,  as  applied  to  a 
thigh-stump,  in  figure  87. 
These  parallel  strips  may  be  used  more  or  less  extensively  upon 
the  limb,  as  the  exigencies  of  the  case  may  seem  to  demand.  This 
bandage  is  really  but  the  extension  of  the  principle  of  that  of 
Scultet's,  the  whole  upper  portion,  b,  figure  86,  being  but  the  bandage 
ofScultet. 

Uses. — This  bandage  is  used  only  in  the  dressing  of  stumps; 
and  it  is  particularly  valuable  where  pressure  is  recjuired, — as  when 
the  flaps  retract,  making  the  wound  gape,  and  thus  leaving  the  bone 
exposed.  In  its  application  the  stump  needs  be  lifted  but  once,  i.  c, 
when  the  bandage,  lying  upon  the  paper,  is  first  slipped  under — a 
dcsideraiinn  wanting  in  all  other  stump-dressings. 


C.aputina  <applie<l. 


tarso-patp:llar  cravat. 

Description.^ — -I.  Two  cravats,  each  one  one  yard  in  length. 
II.  A  third  cravat  one-half  the  length  of  the  others. 


MANUAL    OF  BANDAGING . 


101 


Application. — Tie  the  smallest  of  the  cravats  about  the  instep, 
FIG.  88.  as  A.     Take,   then,   one  of  the  re- 

maining, place  its  centre,  b,  above 
the  patella,  and  carry  both  ends 
backwards  around  the  lower  portion 
of  the  thigh,  crossing  them  at  the 
back,  and  bringing  them  diagonally 
downwards  and  forwards,  below  the 
patella,  there  tying.  Take,  then,  the 
third  cravat  and  carry  it  through,  to 
its  centre,  c,  the  "  stirrup "  formed 
by  the  one  first  applied,  a,  and  con- 
duct each  extremity,  one  upon  each 
side  of  the  leg,  up  and  under;  the 
loops  of  the  one  appHed  at  the  pa- 
tella, B.  Flex  the  foot,  to  a  sufficient 
degree,  upon  the  leg,  and  then 
fasten  the  cravat  last  applied  by 
pinning  the  extremities. 
Uses. — Mayor  proposed  this  bandage  for  cases  of  knee-pan 
fractures.  It  is  more  suitable  in  cases  of  the  rupture  of  the  ligamentum 
patellae,  in  transverse  wounds  of  the  instep,  and  in  cases  of  talipes 
equinus,  where  extension  of  the  tendon  Achillis  is  required ;  or, 
after  its  division,  to  properly  place  the  foot  that  it  may  overcome 
this  deformity. 


Tarso-patellar  Cravat. 


TAKSO-CRUEAL    CRAVAT. 

Description. — I.  Two  cravats,   each  one  one  yard  in  length. 

II.  A  third  cravat  eighteen  inches  in  length. 

Application. — So  similar  to  that  of  the  preceding  that  no 
wood-cut  is  necessary ;  the  only  difference  being  that  the  second  one 
(b,  in  the  preceding  figure)  is  to  be  applied  about  the  upper  portion 
of  the  thigh,  and  to  this  the  long  cravat  c  (of  the  preceding  cut)  is 
to  be  fastened,  after  it  has  been  passed  through  the  cravat-stirrup,  a, 
about  the  foot. 
14 


102 


BANDAGES  OF  THE  LOWER  EXTREMITY 


Uses. — The  mechanism  of  this  bandage  is  to  forcibly  flex  the 
foot,  and  at  the  same  time  the  leg,  upon  the  thigh;  and  hence  is  use- 
ful in  cases  of  rupture  of  the  soleus  or  gastrocnemius  muscles,  or 
their  common  tendon,  and  in  transverse  wounds  of  the  back  of  the 
heel  or  leg. 

Variety. — Tarso-pelvic  Cravat.  The  only  difference  here  being 
that  the  cravat  is  tied  about  the  pelvis  instead  of  about  the  upper 
portion  of  the  thigh.  The  uses  are  identical  to  those  of  the  Tarso- 
crural. 


SCAPULO-TIBIAL    TRIANGLE    AND    CRAVAT. 

(Sling  for  the  Inferior  Extremity.) 

Description. — I.  A  cravat,  or  scarf,  two  yards  in  length. 

II.  A  triangle  whose  base  mea- 
sures one  and  one-half  yards,  and 
whose  height  is  two  feet. 

Application.  —  Tie  the  scarf 
over  the  shoulder  opposite  the 
injured  leg,  as  a.  Place  the  base 
of  the  triangle,  near  its  middle,  at 
the  anterior  surface  of  the  leg,  b,  and 
carry  the  two  ends  upwards  and  tie 
into  the  "sUng"  termed  by  the 
cravat.  Then  pin  the  apex  of  the 
triangle  at  the  outer  side  of  the 
leg,  to  the  base  of  the  triangle,  as 
at  c  ;  folding  it  across  the  firont  of 
the  knee,  so  as  to  prevent  the  mem- 
ber slipping  too  far  forwards,  and 
out  of  its  support. 

Uses.— To  support  either  lower 
extremity,  when  injured  ;  or  to  hold 
moderately  flexed  the  leg  upon  the  thigh.  Is  a  very  convenient 
and  useful  dressing. 


Scapulo-tibial  Triangle  and  Cravat. 


MANUAL   OF  BANDAGING. 


103 


SLING   OF   THE    LOWER   EXTEEMITY. 

Description. — A  cravat  long  enough  to  reach  from  the  neck  to 
FIG-  ^^-  the  foot,  and  back  again,  to  tie  about  it. 

It  is  also  made  from  webbing,  with  a 
buckle  attached,  as  represented  in  the  cut. 
Application. — The  limb  having 
been  properly  bandaged,  the  cravat  or 
webbing,  at  its  centre,  is  to  be  passed 
underneath  the  foot,  and  then  tied  about 
the  neck. 

Uses. — As  a  support,  merely,  of  an 
injured  foot,  leg,  knee,  or  thigh,  when 
walking  with  crutches  is  allowable. 

CROSS  OF  THE  GROIN. 
(Ascending  Spica  of  the  Groin. ) 

Description. — This  should  be  made 
from  a  roller  nine  yards  in  length  by  two 

Sling  of  the  Lower  Extremity.        •      ,         •         .  ,  , 

mches  m  width. 
Application. — Place  the   initial   end   of   the  bandage  at  the 
j,jQ_  9j_  front  of  the  abdomen,    i,  and 

confine  by  the  two  horizontal 
circular  turns  2  and  3.  Con- 
tinue on  in  the  same  course  till 
you  come  to  the  ilium  of  the 
injured  side,  when  you  descend 
obliquely  across  the  inguinal 
region,  passing  down  between 
the  thighs,  thus  completing  the 
fourth  course  of  the  bandage. 
You  then  encircle  the  thigh  of 
the  same  side,  and,  on  coming 
to  its  anterior  surface,  ascend 
obliquely  across  the  inguinal  re- 
gion, from  without  inwards,  upon 
the  abdomen,  to  the  opposite  side  of  the  body,  thus  completing  the 


Cross  of  the  Groin. 


104  BANDAGES    OF   THE   LOWER    EXTREMITY. 

fifth  course.  Course  6  is  made  similarly  to  course  4 ;  course  7,  to 
course  5  ;  course  8,  to  course  6  ;  course  9,  to  course  7  ;  and  so  on 
until  the  roller  is  nearly  exhausted,  when  you  make  one  or  two 
horizontal  turns  about  the  abdomen,  and  confine. 

Uses. — For  maintaining  dressings  upon  the  inguinal  region  ; 
also  for  making  compression  upon  any  of  the  enlarged  glands  in  this 
neighborhood,  and  for  maintaining  a  replaced  hernias. 

Variety. — Descendmg  Spica  of  the  Groin.  This  differs  from 
the  preceding  only  in  having  the  courses  of  the  bandage  across  the 
groin  run  from  above  downwards ;  that  is,  course  4  of  the  bandage 
is  put  in  the  line  of  course  16 ;  course  5,  in  the  line  of  course  17  ; 
course  7,  in  the  line  of  course  15,  and  so  on. 

TEAPEZOIDAL    T  OF  THE  GEOIN. 

Description. — I.  A  piece  of  cloth,  cut  to  the  shape  of  a 
trapezoid,  sufficiently  large  to  cover  the  groin. 

II.  To  one  of  the  angles  of  the  base  of  this  trapezoid,  the 
external  superior  (as  a  in  the  following  figure),  stitch  a  small  roller, 
two  yards  in  length  by  one  and  three-quarter  inches  in  width. 

III.  To  the  other  extremity  of  the  base,  b,  stitch  another  roller 
of  the  same  width,  but  three  yards  in  length. 

IV.  Across  the  apex  of  the  trapezoid  stitch  another  roller, 
having  the  same  width,  but  being  two  feet  in  length,  as  at  c. 

Application.^ — Place  the  base,  a-b,  of  the  trapezoid  above  the 
FIG.  92.  injured  groin,   and   encircle  the 

abdomen  with  the  roller  a,  as  a'. 
Conduct  the  roller  b  across  the 
crest  of  the  opposite  ilium,  then 
diagonally  downwards  across  the 
sacrum  and  nates  to  a  point 
considerably  below  the  great 
trochanter,  and  then  obliquely 
upwards  across  the  trapezoid,  as 
b',  and  the  abdomen,  to  pass 
around  the  back  again,  and  tie 
with  the  portion  a  at  the  side. 
Trapezoidal  T  of  the  Groin.  pin  the  portion  b'  to  the  trape- 


MANUAL  OF  BANDAGING. 


105 


zoidal  piece  of  lint,  and  also  to  the  roller-turn  a'.  This  done,  en- 
circle the  thigh  with  the  roller  from  the  inferior  portion  of  the 
trapezoid,  as  at  c,  confining  it  with  a  pin. 

Uses. — For  maintaining  cataplasmata  and  other  dressings  to  the 
groin  and  anterior  surface  of  the  thigh,  when  the  patient  is  kept  in 
the  recumbent  posture.  Is  of  little  or  no  value  in  exercising  com- 
pression, and  hence  does  not,  in  this  particular,  take  the  place  of 
the  Spica  of  the  Groin  just  described. 


CRURO-INGUINAL   TRIANGLE. 

Description. — A  triangle  one  yard  in  length  across  its  base, 
and  some  eighteen  inches  in  height. 

Application  — Place  the  base  of  the  triangle,  a,  just  above  and 
FIG.  93.  to  the  inside  of  the  anterior  spine  of 

the  ilium,  the  right  for  example,  in  an 
oblique  manner ;  carry,  then,  the  in- 
ternal (inferior),  extremity  about  the 
injured  thigh,  from  within  outwards, 
and  pin,  as  at  b.  Then  conduct  the 
other  extremity  around  the  body, 
bringing  it  forwards  and  obliquely 
downwards  across  the  opposite  inguinal 
region,  c,  and  pin  to  the  base  of  the 
triangle.  The  apex  is  then  to  be  car- 
cruro-inguinai  Triangle.  ^.-^^  backwards  and  downwards  across 

the  o-luteal  region  of  the  injured  side,  and  confined  as  usual. 

Uses. — This  bandage  of  Mayor's  is  very  useful  in  confining 
dressings  to  one  of  the  nates,  upper  part  of  the  thigh,  or  one  of  the 
inguinal  regions. 

Variety. — The  Cruro-pelvic  Triangle  is  made,  essentially,  in  the 
same  manner ;  the  only  difference  being  that  the  base  of  the  triangle 
is  apphed  farther  up  upon  the  abdomen,  thus  adapting  it  more 
especially  for  confining  dressings  about  the  crest  of  the  ilium,  and 
the  lower  lateral  portion  of  the  abdomen. 


106 


BANDAGES    OF   THE   LOWER    EXTREMITY. 


FIG.   94. 


CRT'RO-PELVIC   CRAVAT. 

(Inguinal  Cravat) 
Description. — A  wide  cravat  one  yard  in  length. 

Application.^ — Place  the  mid- 
dle of  the  cravat  at  the  pubic 
region,  as  a,  carry,  then,  the  su- 
perior extremity,  or  the  one  to  the 
opposite  of  the  diseased  side, 
obliquely  up  across  the  opposite 
inguinal  region,  over  the  iliac  crest, 
and  around  the  back;  then  con- 
duct the  other  extremity  about  the 
thigh  of  the  injured  side,  as  b, 
mounting  up  across  this  inguinal 
Cruro-peiYic  Cravat.  region,    and  at  last  tie   with   the 

other  extremity  at  the  side,  as  at  c. 

Uses. — For  confining  dressings  upon  the  .supra-pubic,  inguinal, 

and  lower  srluteal  regions. 


SACRO-BICRURAL   CRAVAT. 

Description. — Two   cravats,    each   four  feet  in  length.     Tie 
them  together  at  one  of  their  extremities. 

FIG.  95.  Application.  —  Place    their 

point  of  tying  at  the  lumbo-sacral 
region,  bringing  both  free  extrem- 
ities, A  and  B,  forwards  and  down- 
wards across  the  inguinal  regions, 
one  upon  each  side;  then  pass  them 
in  between  and  around  the  thighs, 
and  conduct  them  obliquely  up- 
wards and  across  the  ilio-pubic 
regions,  a'  and  b',  to  confine  them 

Sacro-bicrural  Cravat.  there  with  pins. 

Uses. — For  confining  dressings  upon  both  groins,  as  in  cases  of 
bilateral  buboes. 


MANUAL    OF  BANDAGING. 


107 


FIG.   96. 


DOUBLE   T   OF  THE  PERINtEUM. 

Description.--!.  A  broad  band,  long  enough  to  encircle  the 
body. 

II.  Two  strips,  each  one  yard  in  length  by  two  inches  in  width, 
sewed  at  right  angles  to  the  broad  band,  one  inch  from  each  other, 
at  its  central  portion. 

Application. — Place  the  cen- 
tre of  the  broad  band  at  the 
lumbo-sacral  articulation,  and  con- 
fine it  about  the  body,  as  at  a. 
Bring  forwards,  between  the 
thighs,  each  of  the  other  strips, 
and  pin  them  to  the  broad  portion 
of  the  bandage,  as  at  B  and  c. 

Uses. — To  maintain  dressings 
upon  the  sacrum,  anus,  perinseum, 
and  vulva. 

Variety. — Simple  T  of  thePeri- 
fKEUfn.  This  differs  from  the  above  only  in  having  a  single  perinseal 
strip.  Is  used  for  the  same  purposes  for  which  the  Double  T  is 
employed. 


Double  T  of  the  Perinseum. 


PERINEAL   CRAVAT. 

Description. — I.  A  broad  bandage  to  encircle  the  abdomen, 
as  in  figure  96. 

II.     A  cravat  two  feet  in  length. 

Application. — Having  applied  the  abdominal  band,  as  in  the 
preceding  cut,  a,  pin  (or  button)  one  end  of  the  cravat  to  the 
sacral  portion  of  the  broad  band ;  pass  the  other  extremity  between 
the  thighs,  and  pin  at  the  pubic  portion  of  the  band. 

Uses. — Similar  to  the  "  T  Bandages  of  the  Perinaeum."  Ladies 
make  use  of  this  cravat  for  protecting  themselves  against  the 
menstrual  flow. 


108 


BANDAGES    OF   THE  LOWER  EXTREMITY. 


SACEO-PUBIC  TRIANGLE. 

Description. — This  should  be  a  triangle  one  yard  in  length, 
by  eighteen  inches  in  height. 

FTG-  97.  Application. — Place  the  base 

of  the  triangle,  a,  at  the  lumbo- 
sacral region,  with  the  apex  down- 
wards, and  carry  the  two  extremi- 
ties forwards  around  the  body, 
tying,  or  pinning,  at  the  front. 
Then  carry  the  apex,  b,  of  the  tri- 
angle forwards  between  the  thighs, 
and  pin,  at  the  pubes,  to  the  tied 
extremities. 

Uses. — To  retain  dressings  up- 
Sacro-pubic  Triangle.  on  the   sacral  and    lower   lumbar 

region,  the  peringeum,  vulva  and  anus. 


FOUR-TAILED  BANDAGE  OF  THE  HIP. 

Description. — A  piece  of  cloth  one  yard  in  length,  by  eight 
inches  in  width,  torn  to  a  four-tailed  bandage ;  see  figure  4,  page  17. 

Applciation. — Place  the  plane  of  the  bandage  over  the  dis- 
eased hip,  and  carry  the  two  superior  ends  around  the  pelvic  brim, 
and  confine  by  tying.  Then  conduct  the  two  inferior  extremities 
about  the  upper  portion  of  the  thigh,  of  the  side  diseased,  and 
fasten  as  usual. 

Uses. — To  confine  cataplasmata  and  similar  dressings,  to  the 
parts  it  covers. 


COXO-PELVIC  TRIANGLE. 

( Triangular  Bonnet  of  the  Nates. ) 

Description. — I.     A  cravat  four  feet  in  length. 
II.     A  triangle  having  a  base  one  yard  in  length  and  a  height  of 
eighteen  inches. 


MANUAL   OF  BANDAGING. 


109 


FIG.  98. 


Application.  —  Encircle  the 
lower  portion  of  the  abdomen  with 
the  cravat  d,  and  confine  by  tying. 
Then  place  the  middle  of  the  base 
of  the  triangle,  a,  below  the  great 
trochanter,  with  the  apex  upwards  ; 
then  encircle  the  thigh  with  the  free 
extremities  of  the  base,  and  confine 
by  tying  as  at  b.  This  done,  carry 
the  apex  of  the  triangle  upwards, 
and  confine  it  to  the  cravat,  as  you 
Coxo-peiYic  Triangle.  See  in  the  wood-cut,  at  c. 

Uses. — To  retain  soft  dressings  to  the  parts  it  covers. 


LUMBO-SCEOTAL  TRIANGLE, 

(Suspensory  Bandage  of  the  Scrotum.) 
Description. — ^I.    A  cravat  sufficiendy  large  to  encircle  the 
body. 

II.    A  triangle  having  a  base  of  fourteen  inches  and  a  height  of 
ten  inches. 

Application. — -Tie  the  cravat,  a-a,  about  the  lumbo-hypogastric 
FIG.  99.  regions.    Place  the  base  of  the  tri- 

angle close  up  to  the  pubes,  be- 
neath the  scrotum,  and  carry  the 
ends,  B,  B,  up  over  the  cravat,  then 
down  beneath  it,  and  forwards 
again,  as  you  see  in  the  cut,  and 
tie  in  front,  as  D.  Carry  the  apex 
of  the  triangle  upwards  across  the 
front  of  the  scrotum,  passing  be- 
neath the  tied  extremities,  and 
beneath  the  cravat,  and  fold  down 
over  and  in  front  of  the  cravat, 
confining  with  a  pin. 

Uses. — As  a  suspensory  bandage  for  the  scrotum,  and  its  con- 
tents, and  as  a  retainer  of  dressingsto  the  parts. 
15 


Lumbo-scrotal  Triangle. 


110 


BANDAGES  OF  THE  LOWER  EXTREMITY 


Description. 

FIG.    100. 


BOUESE    OF    THE    SCROTUM. 
—I. 


Bourse  of  the  Scrotum. 


A  piece  of  cloth,  folded  to  a  double  square, 
six  or  eight  inches  in  size.  Cut  of  the 
folded  corners  by  the  dotted  lines,  a-b, 
and  c-D,  in  figure  loo.  It  is  then  to  be 
stitched  across,  from  a  to  b,  and  from  c 
to  D. 

II.  Around  the  upper  portion  of  this, 
e-d-e',  is  to  be  stitched,  at  its  central 
portion,  a  roller  two  inches  in  width  by 
four  feet  in  length. 

III.  To  each  inferior  extremity,  a  and 
a',  there  is  to  be  stitched  a  roller  one 

inch  in  \\'idth  by  two  feet  in  length. 

Application. — Place  the  scrotum  in  the  bourse,  and  draw  the 
penis  through  the  opening  left  at  D,  c.  Conduct  the  broad  band 
around  the  body,  and  confine  by  tying.  The  other  tAvo  strips,  that 
are  attached  to  the  inferior  portion  of  the  bandage,  are  to  be  carried 
between  the  thighs,  across  the  perinasum,  and  up  over  the  buttocks, 
one  upon  each  side  of  the  body,  and  confined  to  the  broad  band 
that  encircles  the  abdomen. 

Uses. — To  retain  dressings  to  the  scrotum,  or  to  exercise  com- 
pression upon  its  contents  ;  but  more  especially  as  a  suspensory 
bandage.  Rubber  makes  a  good  substitute  for  the  linen  bourse 
when  compression  is  demanded,  as  proposed  by  Richard  and  Nela- 
ton,  in  cases  of  voluminous  varicoceles  and  sarcoceles.  Nelaton  em- 
ployed, in  these  cases,  small  tubes  caoutchouc  vulcanise,  and  by  so 
doing  forestalled  the  American  surgeon  in  a  similar  use  of  the  capote. 
Compression  can  also  be  maintained  by  the  use  of  adhesive  strips, 
which  method  is  fully  described  in  the  Chapter  upon  Strappings. 


DOUBLE    T    OF    THE    TEU^'K. 

Description. — I.  A  large,  quadrilateral  portion  of  cloth  to  en- 
circle the  abdomen. 

II.  Two  strips,  sufticiently  long  to  pass  over  the  shoulders,  to  act 
as  "suspenders.'"' 


MANUAL    OF  BANDAGING. 


Ill 


III.  Two  strips  of  the  same  length  to  be  passed  across  the 
perinseum. 

Application. — Having  encircled  the  abdomino-lumbar  regions 
-p-^^^  101,  with  the  broad   quadrilat- 

eral portion  of  the  bandage, 
pass  the  two  portions,  b, 
b',  of  the  bandage  from  the 
posterior  to  the  anterior 
surface,  and  confine  with 
pins  to  the  main  bandage. 
Then,  pinning  the  remain- 
ing two  strips  to  each  lum- 
bar region  of  the  broad 
bandage,  conduct  them  for- 
wards, across  the"  perinse- 
um,  and  upwards  to  the 
abdomen,  there  to  confine; 
having  care  to  have  crossed 
them  upon  the  perinaeum, 
Double  T  of  the  Trunk.  gQ  tj^^^  t^g  Strip  fastened 

upon  the  right  of  the  patient,  posteriorly,  shall  be  fastened  upon  the 
left,  anteriorly,  etc. 

Uses. — As  a  dressing  after  paracentesis  abdominis,  or  eviscer- 
ating wounds.     Also,  as  a  retainer  of  pubic  and  perinseal  dressings. 

Note. — For  the  Spiral  of  the  Abdotnen,  see  page  7  2  ;  and  for  the 
Circular- Quadrilateral  of  the  Abdomen  (and  the  Abdomen  and 
Thorax\  and  the  Dorsal  Cervico-Sternal  Triangle,  see  page  74. 

The  uses  of  these  bandages  are  similar  to  those  for  which  the 
Double  T  of  the  Trunk  is  employed. 


112  IMMOVABLE   DBESSINGS. 


CHAPTER    X. 
IMMOVABLE    DRESSINGS. 

This  variety  of  surgical  dressing  has  long  been  known  to  the 
profession.  The  Father  of  Medicine,  Hippocrates,  was  quite  con- 
versant with  the  use  of  this  apparatus,  and  used  it  in  most  of  his 
cases  of  fractures.  His  teachings  upon  the  subject  seem  to  have 
been  lost  sight  of,  however,  during  the  many  centuries  that  have 
followed  him,  and  so  the  introduction  of  this  style  of  dressing,  during 
our  later  years,  has  been  accredited  to  the  reviver  as  a  new  discovery. 
Resurgarn  is  the  epitaph  of  all  things  surgical,  and  the  history  of  the 
succeeding  ages  is  but  the  unfolding  of  the  truthfulness  of  the  pro- 
phecy. In  other  words,  a  modern  inventor  (so-called)  can  hardly 
hope  to  be  anything  further  than  a  reviver  of  some  forgotten 
principle. 

The  stiffening  substance  made  use  of  by  Hippocrates,  was  wax, 
rosin,  and  cerate,  instead  of  the  plaster-of-Paris,  starch,  dextrine, 
etc.,  made  use  of  by  the  moderns.  This  was  well  rubbed  into  the 
the  bandage,  and  upon  each  succeeding  turn  of  the  applied  roller, 
besides  being  applied  to  the  compresses,  packings,  and  even  the 
limb  itself. 

THE  BAVAEIAN  PLASTER  SPLINT. 

Description. — Take  two  pieces  of  Canton  flannel,  of  length 
sufficient  for  the  injured  member,  and  of  width  sufficient  to  overlap 
slightly  when  brought  around  the  limb.  Those  for  the  leg  would 
resemble  the  pieces  of  the  leg  of  a  stocking  when  it  is  cut  vertically. 
The  pieces  should  now  be  stitched  together  at  the  back,  one  to  the 
other,  down  the  median  line. 

Application. — Spread  the  bandage  out  under  the  hmb,  so  that 
the  stitched  portion  will  correspond  to  the  back  of  it;  carry,  now, 


MANUAL    OF  BANDAGING. 


113 


FIG.   102. 


the  upper  piece  about  the  Hmb,  and  fasten  by  stitches  or  pins,  as 

you  see  in  the  wood-cut, 
figure  1 02,  A,  A,  A.  The 
member  now  being  firmly 
held,  an  assistant  mixes 
the  plaster-of-Paris  with 
about  an  equal  bulk  of 
water.  This  is  then  poured 
over      the      limb,      when 

The  Bavarian  Plaster  Splint.  it    is    enwrapped    with     its 

covering,  a  a  a,  and  evenly  distributed  over  its  surface.  The  edges 
p.  B  B  B  of  the  other  piece  of  flannel  are  then  caught  up  and  brought 
forwards  around  the  limb,  and  confined  by  a  suitable  roller,  or  by 
straps.  The  plaster  soon  hardens,  and  then  the  edges  of  the  band- 
age may  be  trimmed,  the  portion  pinned  or  sewed  can  be  un- 
fastened, and  you  have  then  an  excellent  splint  for  a  member.  The 
stitching  at  the  back  plays  the  office  of  a  hinge,  thus  facilitating  its 
removal  and  application. 

Caution. — In  this,  and  all  other  hard  dressings  intended  to 
remain  some  time  upon  the  limb,  you  must  guard  all  unevennesses 
of  the  member,  as  the  region  of  joints,  etc.,  with  abundant  layers  of 
cotton-wool,  as  the  bandage  is  apt  to  contract  slightly  after  its  appli- 
cation, thus  engendering  gangrene.  Generally  it  is  best  to  wait  three 
or  four  days  after  simple  fractures,  as  of  fibula  or  tibia,  with  no  dis- 
placements, before  the  strictly  immovable  dressing  is  applied.  In 
other  cases  ten  or  twelve  days  is  about  the  usual  time  recommended 
by  authors. 

Uses. — As  a  support  to  a  dislocated  member,  fractured  bones, 
or  separated  cartilages  ;  also  in  inflammation  of  joints  when  "  absolute 
rest "  is  to  be  sought. 

If  there  should  be  any  undue  swelling  of  the  limb,  or  over-much 
pain  be  caused  by  the  pressure  of  the  bandage,  of  course  it  should 
be  at  once  removed.  The  following  rules,  from  Hippocrates,  are 
clear  and  decisive,  and  form  an  excellent  guide  for  the  surgeon  in 
bandaging,  either  with  the  movable  or  immovable  apparatus. 

Quoting  from  Utpi  ayiiajv,  §5:  "These  are  the  signs  if  the 
patient  has  been  properly  bandaged  :  if  you  ask  him  if  the  limb  feels 


114  IMMOVABLE  DRESSINGS. 

tight,  he  says  it  does,  but  moderately  so,  especially  about  the  seat  of 
fracture.  And  these  are  the  symptoms  of  a  moderately  tight  band- 
age :  for  the  first  day  and  night  the  patient  fancies  the  tightness  does 
not  diminish,  but  rather  increases ;  on  the  next  day  there  is  a  soft 
swelling  [oedematous]  in  the  hand,  or  foot,  for  this  is  a  sign  of  mod- 
erate compression ;  but  at  the  end  of  the  second  day  the  compres- 
sion should  feel  less,  and  by  the  third  day  the  bandage  should  seem 
loose.  If  any  of  these  symptoms  be  wanting,  you  may  conclude 
that  the  bandage  is  slacker  than  it  should  be ;  or  if  any  of  them  be 
in  excess,  you  may  infer  the  compression  is  more  than  moderate 
[/.  e.  hurtful]." 

THE  COMMON   PLASTER    DRESSING. 

{Pirogoff's  Plaster  Bandage.) 

Description  and  Application. — Having  first  well  padded  the 
limb  with  cotton-wool,  envelope  it  with  a  flannel  roller,  neatly, 
evenly,  and  somewhat  tightly.  Then  make  your  plaster  ready,  by 
getting  it  to  the  consistency  of  cream,  by  adding  to  it  about  an  equal 
bulk  of  water  (mixing  up  but  one-half  a  teacup  of  it  at  a  time); 
into  this  mixture  dip  the  pieces  of  muslin  (thin)  that  you  have  pre- 
pared in  suitable  strips,  and  squares,  and  begin  laying  them  evenly 
around  the  Jimb.  As  soon  as  the  plaster-mixture  begins  to  harden 
in  the  dish,  throw  it  out  and  mix  up  a  new  batch,  continuing  the 
application  of  the  muslin  strips,  as  before.  You  will  find  strips  two 
to  four  inches  in  width,  and  long  enough  to  go  one  and  one-half 
times  about  the  member,  the  most  convenient  size  for  applying, 
except  in  the  region  of  joints ;  here  squares,  or  oblong  squares,  are 
very  serviceable.  When  you  have  the  whole  to  the  requisite  thick- 
ness to  furnish  efficient  support  to  the  member,  encase  the  whole 
dressing  with  a  layer  of  the  gypsum,  by  pouring  a  portion  upon  the 
limb  enveloped  with  plaster-cloths,  along  its  entire  length. 

The  same  cautions  should  be  obsers-ed  here  as  in  the  preceding 
variety,  remembering  this  is  ■Sl  pernuvient  dressing.  The  limb  should 
be  kept  immovable  during  the  application,  and  very  quiet  for  some 
time  afterwards,  so  that  the  plaster  may  not  be  cracked  whilst 
hardening.     After  this,  if  the  condition  of  the  patient  permits,  the 


MANUAL  OF  BANDAGING.  115 

member  can  be  swung  in  a  "  sling,"  and  the  patient  permitted  to 
walk  or  ride  out  with  little  or  no  danger. 

Uses. — These  are  similar  to  those  just  enumerated  under  the 
Bavarian  bandage. 

1 1  might  be  well  to  notice  that  the  hardening  of  the  plaster  can 
be  de/aycd  hy  the  addition  of  a  little  stale  beer,  or  size,  to  the  mix- 
ture; or  it  can  be  auderated  by  the  addition  of  sodic  chloride  (com- 
mon salt),  or  by  using  warm  water  to  "  wet  it  up."  It  is  best  to 
paint  the  whole,  after  it  is  dry,  with  an  application  of  glue,  varnish  or 
albumen,  so  as  to  prevent  "chipping"  of  the  exterior.  This  band- 
age is  also  made  of  starch. 

STAKCH,  OR  PLASTER,   ROLLER. 

Description  and  Application. — Having  a  bandage  (of  the 
required  length  and  width)  of  some  meshy  or  loosely  woven  material, 
fill  it  with  the  powdered  gypsum,  or  starch,  by  rubbing  it  in,  and 
then  roll  up  firmly  and  evenly.  Have  the  Hmb  of  your  patient  pro- 
tected with  the  cotton-wool,  ther  dip  the  roller  into  water,  so  that 
it  becomes  wet  throughotit,  then  apply  it  as  you  would  a  common 
"spiral"  or  reversed  bandage  to  the  same  member.  It  quickly 
hardens,  and  you  have  then  quite  a  firm  casing  for  your  patient's 
limb.  It  is  not  so  secure  or  firm  as  the  Starch  or  Plaster  Dressing 
just  described,  yet  is  very  useful  in  many  cases. 

Varieties. — The  roller  may  be  prepared  as  above,  and  on  each 
succeeding  turn  of  it  about  the  member,  it  may  be  freely  brushed 
over  with  the  plaster-cream,  starch,  gluten,  silicate  of  potash,  glue, 
or  whatever  hardening  substance  is  used,  as  in  the  method  em- 
ployed by  Hippocrates  when  using  his  compound  of  rosin,  wax,  and 
cerate ;  at  last  brush  the  whole  over  with  a  thin  layer  of  the  sub- 
stance made  use  of. 

In  all  of  these  "  hard  "  bandages,  it  is  well,  a  day  or  two  after 
its  application,  to  give  the  whole  a  coating  of  varnish,  gluten,  or 
gum,  in  order  to  prevent  the  bandage  "  chipping." 

This  form  of  plaster  dressing  war  introduced  by  the  Dutch 
surgeon  Maythysen. 

The  Bandage  of  Scultel  has  also  been  made  use  of  to  make  the 


116  IMMOVABLE  DRESSINGS. 

"  immovable  dressings ; "  but  it  is  not  secure  enough  to  come  into 
general  use.  It  is  the  parallel  strips  seen  at  b,  figure  86,  page  99, 
and  is  to  be  similarly  applied. 

T/ie  Silica  Bandage  is  now  considerably  used.  It  dries  more 
readily  than  the  gypsum,  and  possesses  the  advantage  of  being 
soluble  in  water,  hence  quite  easily  removed. 

The  Parrafin  Bandage  of  Mr.  Tait  is  recommended  for  open 
wounds,  as  it  does  not  absorb  the  secretions  as  do  the  other  varieties 
of  dressings.  The  substance  is  kept  melted  by  having  its  container 
in  hot  water.     The  roller  is  to  be  passed  through  it  as  it  is  applied. 

FENESTEATED  IMMOVABLE  DKESSINGS. 

Description. — Any  of  the  preceding  varieties  of  immovable 
bandages  may  have  openings  left  in  them  through  which  the  secre- 
tions may  find  ready  exit. 

It  would  be  well  to  coat  the  margins  of  the  fenestrse  for  some 
distance  around  them  with  parrafin,  so  as  to  prevent  the  absorbtion 
of  the  fluids  by  the  dressing. 

If  the  parrafin  should  happen  to  crack,  it  can  be  easily  mended 
by  passing  a  hot  spatula  over  it. 

Uses. — These  are  apphed  in  cases  of  compound  fractures,  or 
where  a  suppurating  surface  would  otherwise  be  covered  by  the 
dressing. 


MANUAL    OF  BANDAGING.  117 


CHAPTER    XL 

UPON     STRAPPINGS. 

In  strapping  a  limb  we  seek  one  or  more  of  the  following  pur- 
poses : 

I.  A  "  support  "  to  the  divided  tissues. 

II.  A  compression  of  the  part  so  as  to  favor  absorb tion  of 
effused  materials,  or  to  prevent  too  exuberant  granulation,  or  herniae. 

III.  To  gain  a  fixed  point  upon  the  member,  so  as  to  be  en- 
abled to  maintain  extension  of  the  same. 

For  one,  or  all  of  these  purposes,  the  common  adhesive  plaster 

of  the  shops  {Emplastru^n  Resina)  is  employed.     The  formula  for 

its  preparation,  according  to  the  American  Phar?nacopcEia,  is  : 

I^.  Resinse  pulveris,  '%  vi ; 

Emplastri  Plumbi,  §  xxxvi. 

This  often  proves  irritating  to  the  skin,  from  the  amount  of  resin 
it  contains,  if  the  plaster  is  to  be  long  applied.  The  irritability  of 
the  plaster  may  be  lessened  by  using  less  resin  in  its  making. 

Baynton,  to  whom  the  profession  is  indebted  for  the  introduction 
of  the  "strapping  treatment"  of  old  ulcers,  made  use  of  a  formula 
containing  but  six  drachms  of  the  rosin  to  a  pound  of  the  lead 
plaster,  less  than  one-half  the  amount  used  in  the  Officinal  formula. 

The  Dublin  College,  and  also  the  British  Pharmacopoeia,  incor- 
porate a  small  amount  of  soap  in  their  adhesive  plaster,  thus  engen- 
dering a  greater  pliability  of  the  dressing. 

The  plaster  is  spread  upon  heavy  muslin,  or  Canton-flannel,  by 
the  aid  of  machinery,  and  comes  to  us  in  rolls  of  several  yards  in 
length.  The  strips  we  use  should  always  be  cut  lengthwise  from  the 
roll;  otherwise  the  cloth  will  "give,"  when  extension  is  made  upon 
it,  thus  loosening  the  plaster  from  its  "  hold  "  upon  the  member. 
16 


118  STRAPPINGS. 

Generally  narrow  strips  are  employed  in  supporting  wounded 
parts,  but  those  from  one  to  two  inches  in  width  when  compression 
or  extension,  is  desired. 

After  the  strips  have  been  cut  they  should  be  heated  by  placing 
the  back  of  the  plaster  to  a  tin  vessel  containing  hot  water,  or  to  the 
stove-pipe,  before  applying  to  the  limb.  They  will  "take  hold" 
much  better  by  so  doing.  If  the  part  to  which  they  are  to  be  ap- 
plied is  hairy,  a  "  clean  shave "  will  be  necessary  before  you  can 
make  a  satisfactory  application,  and  will  save  much  trouble  and  pain 
when  you  come  to  remove  them. 

In  removing  adhesive  strips  from  a  wound  that  is  uniting,  care 
should  be  exercised  lest  you  pull  the  lips  of  the  wound  assunder.  If 
you  support  the  wound  with  your  finger,  and  remove  each  end  of  the 
strip  up  to,  and  not  crossing  over,  the  uniting  line  of  the  divided 
structures,  you  will  reduce  this  danger  to  a  minimum. 

The  portion  of  the  plaster  adhering  to  the  limb,  after  the  strips 
have  been  removed,  is  best  cleaned  off  by  first  rubbing  with  olive 
oil,  vinegar,  or  turpentine,  and  then  washing  away  with  soap.  The 
surgeon's  fingers  are  readily  cleansed  in  the  same  way. 

Oftentimes  you  will  find  the  plaster  discolored  when  appHed  to  a 
suppurating  member.  This  is  owing  to  a  decomposition  of  the  lead 
in  the  plaster,  due  to  the  action  of  the  secretions  upon  it. 


FOR  THE  FOOT  AND  ANKLE. 

Application. — Having  cut  your  strips  one  or  one  and  one-half 
FIG.  103.  inches  in  width,  and  of  sufficient  length  to  cross 

over  the  end  first  applied,  as  you  see  in  the 
figure,  you  place  the  centre  of  the  strip  over  the 
back  of  the  heel,  and  bring  one  end,  i,  down 
firmly,  and  somewhat  forcibly,  to  the  5  th  meta- 
tarso-phalangeal  articulation..  Then  seize  the 
opposite  end  of  the  strip,  and  bring  it  equally 
firmly  down  over  the  tarsus,  2,  to  the  ist  meta- 
tarso-phalangeal  articulation.  The  other  strips, 
3,  5,  and  so  on,  are  applied  in  a  similar  figure- 
For  the  Foot  and  Ankle,     ^f.g  manner,  having  care  to  overlap  each  pre- 


MANUAL  OF  BANDAGING. 


119 


ceding  one  a  portion  of  its  width.  You  will  find  you  can  exercise 
almost  any  amount  of  pressure  by  adhesive  strips  so  laid,  and  care 
should  be  used  lest  you  interfere  too  much  with  your  patient's  com- 
fort, and  so  have  to  take  them  off  before  their  therapeutical  effect 
may  be  accomplished. 

Variety. — Any  portion  of  the  body,  when  compression  is  de- 
sired, is  wrapped  in  a  similar  figure-of-8  style,  ulcerated  surfaces 
being  included  in  the  strappings.  It  is  really  surprising  the  way 
some  chronic  (especially  varicose)  ulcers  will  improve  after  a  week's 
treatment  of  good  and  vigorous  strapping,  although  at  the  time  of 
their  application  they  may  be  somewhat  painful  to  the  patient. 


FOE  WOUNDS. 
Application. — Having  your  strips  cut  of  the  requisite  length 


FIG.    104. 


FIG.   105. 


For  Superficial  Cuts.  For  Deep  Cuts. 

(if  the  wound  be  not  deep  they  need  not  surround  the  Hmb,  but  if 
the  cut  be  to  the  bone,  large  enough  to  a  little  more  than  encircle 
the  limb),  you  begin  at  the  bottom  of  the  wound  (i,  in  figures  104 
and  105)  to  apply  them,  the  lips  being  held  approximated  by  an 
assistant.  The  first  strip  having  been  applied,  you  follow  in  the 
same  manner  with  the  remaining  ones,  having  care  not  to  overlay 
either  angle  of  the  wound,  or  to  apply  them  so  closely  that  pus  will 
not  have  a  free  escape.     Some  surgeons  prefer  to  suture  the  lips  of 


120  STRAPPINGS. 

the  wound,  and  then  apply  the  plaster-strips  between  the  sutures. 
But  if  the  form  of  strapping  represented  in  figure  105  be  used,  sut- 
ures will  be  rarely  needed. 


FOR  THE  TESTICLE. 

Application. — Having   the   parts  shaven,   have   your  patient 
stand  against  the   edge  of  a  table,   or  with  his  back  to  the  wall, 
FIG.  106.  keeping  the  legs  separated.     You  then  seize 

the  diseased  testis  with  your  left  hand,  sep- 
arate it  from  its  fellow,  and  press  it  as  far  as 
possible  into  the  scrotal  sac,  thus  making  its 
coverings  as  tense  as  may  be.  A  short  roller, 
having  a  width  of  one-half  or  three-quarters  of 
an  inch,  is  then  wound  three  or  four  times 
about  the  upper  portion  of  the  scrotum,  en- 
croaching somewhat  upon  the  epididymis,  as 
I  in  the  wood-cut,  thus  confining  the  testis. 
For  the  Testicle.  This  roller  is  then  fastened  by  a  short  piece  of 

the  adhesive  plaster.  You  then  pass  the  strips  2  and  3  (which  are 
one-half  or  three-quarters  of  an  inch  in  width,  and  long  enough  to 
go  perpendicularly  around  the  gland),  completely  around  the  testis, 
beginning  them  at,  and  u/>on,  the  previously  applied  roller,  and  end- 
ing them  there.  This  should  be  continued  until  the  whole  organ 
has  been  thus  enwrapped.  Then,  taking  long  pieces  of  strapping, 
one-half  an  inch  in  width,  encircle  the  gland  spirally  from  the  bot- 
tom, 4,  5,  to  the  top,  overlapping  each  preceding  turn,  finishing 
them  over  the  roller  that  was  first  applied. 

Uses. — In  chronic  enlargements  of  the  testis,  or  in  some  cases 
of  hydrocele.  After  a  day  or  two's  application  the  organ  will  be 
found  to  have  shrunken  ;  then  the  dressing  is  to  be  removed,  and 
reapplied. 

Variety. — See  page  no,  upon  the  hii?es  caoictchouc  vidcanise,  of 
Nelaton.  The  Capote  is  also  made  a  legitimate  use  of  in  these 
cases.  In  both  instances  the  roller,  i,  is  to  be  applied  before  the 
rest  of  the  dressing.  The  ring  of  the  capote  should  rest  upon  the 
applied  roller. 


MANUAL    OF  BANDAGING .  121 

FOR  THE  BREAST. 

Description.-  -The  strips  having  been  cut  to  a  width  of  one 
and  one-half  or  two  inches,  and  a  length  of  some  thirty  inches,  they 
are  ready  for 

Application. — The  Mamma  being  supported  by  an  assistant 
you  fasten  one  end  of  the  strip  over  the  spine  of  the  scapula  of  the 
diseased  side,  and  bring  it  down  under  the  same  axilla,  and  then 
pass  it  diagonally  upwards  across  the  chest,  encroaching  upon  the 
gland,  to  and  over  the  opposite  shoulder,  there  ending  ;  you  thus 
follow  course  13  of  the  Cross  of  One  Mamma  figured  upon  pa.ge  78. 
The  other  strips  should  be  applied  in  a  similar  manner,  only  en- 
croaching upon  the  gland  more  and  more,  until  the  necessary  sup- 
port has  been  given. 

If  compression  is  desired,  cross  strips  can  be  run  diagonally  down- 
wards across  the  chest,  from  over  the  shoulder  of  the  diseased  side 
to  the  hepatic  region. 

An  American  surgeon  has  taken  advantage  of  the  expansibility 
of  sponge  in  maintaining  compression  of  the  mamma.  The  sponge 
(a  large  one)  is  thoroughly  cleansed  and  impregnated  with  some 
antiseptic,  and  then  pressed  between  two  flat  surfaces  until  it  be- 
comes dry,  and  as  flat  as  possible.  It  is  then  firmly  strapped  or 
bound  upon  the  breast  with  some  one  of  the  breast  bandages  which 
have  been  described,  and  is  gradually  made  to  expand  by  moistening 
with  water,  if  the  secretions  from  the  gland  or  sore  be  not  sufficient 
for  this  purpose. 

Uses. — As  a  support  of  an  inflamed  or  hypertrophied  breast. 
Also,  when  compression  is  used,  as  a  therapeutic  agent  in  the  treat- 
ment of  any  of  the  various  forms  of  abscess  that  may  arise  within 
or  about  the  gland. 

FOR    EXTENSION  OF  THE   LEG. 

Description. — Two  broad  and  somewhat  tapering  adhesive 
strips,  of  a  length  sufficient  to  reach  from  the  knee-pan  to  below  the 
foot  and  tie. 

II.  Several  narrow  strips  of  the  same  material  to  surround  the 
limb  when  the  extension  strips  are  applied. 


122 


STRAPPINGS. 


Application. — The  broad  strip,  a-b,  is  warmed  and  applied  to 
FIG.  107.  the  side  of  the  leg,  while  its  fellow  is  made 

to  do  similar  service  upon  the  other  side  of 
the  member.  The  narrow  adhesive  strips,  c 
and  D,  are  then  applied  spirally  about  the 
leg,  as  confiners.  The  inferior  ends,  b,  of 
the  two  side  strips  are  then  tied  together, 
and  a  wedge  of  wood,  a  little  longer  than  the 
foot  is  wide,  is  placed  within  the  noose,  to 
which  the  weight  is  attached.  The  wood  is 
used  to  prevent  the  chafing  and  constriction 
of  the  foot,  which  would  otherwise  occur, 
from  the  bringing  together  of  the  two  inferior 
ends  of  the  extending  strips,  as  soon  as  the 
weight  was  attached. 

Uses. — In   cases   of  fracture   where    extension   is    demanded. 
Also,  in  chronic  arthritis,  and  for  overcoming  vicious  contractions. 

Variety. — This  dressing  may  be  applied  to  the  upper  extremity, 
though  an  occasion  rarely  calls  for  its  use  there. 


For  Extension  of  the  Leg 


MANUAL   OF  BANDAGING. 


123 


CHAPTER    XI  I. 

KNOTS. 

Ligatures  were  introduced  to  the  profession  by  Ambroise  Pare. 
Previous  to  his  time  the  "  actual  cautery,"  or  the  cautery  of  boiHng 
oil,  was  made  use  of  for  arresting  haemorrhage.  Ligatures  are  con- 
fined by  knotting  their  extremities  closely  down  upon  the  divided 
vessel  they  surround.  Various  styles  of  knots  are  employed,  though 
we  shall  limit  ourselves  to  a  description  of  but  three. 

THE  SUEGEON'S  KNOT. 

Description. — This  is  formed  by  passing  one  extremity  twice 
about  the  other,  in  making  the  noose  ;  and  hence  makes  a  more  bulky 
knot.  Sometimes  the  first  knot  of  a  ligature  is  the  common  single 
knot,  and  then  the  Surgeon's  knot  is  made,  thus  securing  it.  The 
objection  to  this  knot  is  its  bulkiness,  though  it  is  in  quite  common 
use  with  some  operators. 


THE  EEEF  KNOT. 

Description. — This  is  the  ligature  knot  in  general  use  among 
surgeons  for  arresting  haemorrhage. 

FIG-  108.  A  "  Granny  "  knot,  b,  is  quite 

frequently  made  for  the  Reef,  a, 
through  inattentiveness  of  the 
surgeon  ;  and  students  almost  in- 
variably make  it  on  their  first 
trial  of  the  Reef  It  is  not  a 
really  bad  knot ;  yet  it  lacks  the 
firmness  and  surety  of  the  Reef. 
The  Reef  and  "Granny"  Knots.  The    Reef  knot,    A,    is   made  by 

first  crossing  the  ends  of  the  ligature  so  that  the  one  held  by  the 
right  hand  shall  be  uppermost.    You  then  pass  the  right  extremity 


124  KNOTS. 

around  that  held  in  the  left  hand,  from  within  outwards  ;  this  makes 
the  first  knot,  which  is  pressed  firmly  down  to,  and  drawn  con- 
strictingly  around,  the  vessel,  by  the  finger  tips.  You  then  cross  the 
ends  again,  so  that  the  extremity  that  was  held  by  the  right  hand, 
when  making  the  first  knot,  shall  still  be  uppermost,  although  con- 
signed to  the  keeping  of  the  left  hand.  The  second  knot  is  then 
made  by  passing  the  end  now  held  by  the  right  hand  (formerly  held 
by  the  left)  around  the  other  extremity,  from  without  inwards,  then 
drawing  it  closely  down  to  its  fellow  by  the  finger  tips  again,  thus 
completing  the  knot  as  a  whole. 

The  secret  in  avoiding  the  Granny  knot,  b,  is  in  keeping  the 
uppermost  end  of  the  first  knot  still  uppermost  when  making  the 
second  one. 

In  pulling  the  ends  of  the  ligature,  to  tighten  the  knot,  always 
have  the  direction  of  the  force  downwards,  or  towards  the  vessel. 
You  will  thus  avoid  jerking  the  noose  from  the  vessel  should  the 
fingers  slip  from  the  thread,  or  the  thread  break. 

CLOVE-HITCH   KNOT. 

Description. — A  strong  crash  towel  is  about  as  good  as  any- 
thing for  making  this  knot.  Previous  to  its  application,  the  part 
over  which  it  is  to  be  applied  should  be  enveloped  with  a  wet  piece 
of  lint;  this  serves  the  double  purpose  of  protecting  the  limb  from 
excoriation,  and  of  preventing  the  slipping  of  the  knot  from  off 
the  extremity  when  making  traction. 

FIG.  109.  Application. — Place  one  of  the  extremities 

of  the  towel,  or  cravat,  over  the  back  of  the 
forearm,  for  example,  as  at  i  ;  pass  now  the 
other  extremity  down  across  the  arm,  and  up 
over  (diagonally  from  below  upwards)  the  one 
first  applied,  as  at  2.  Ascend  the  arm  a  little 
space,  and  then  make  another  horizontal  turn 
about  it,  bringing  the  end  up  under  the  course 
2,  thus  finishing  course  3. 

Uses. — For  extension  of  a  member  during 
ciove-wtch  Knot.         reduction   of   a   dislocation.      More    especially 
applied  to  the  superior  extremity. 


MANUAL    OF  BANDAGING. 


125 


M.    GEEDY'S    EXTENSION    KNOT. 

Description. — This  knot  is  executed  with  a  cravat  one  and 
one-half  yards  in  length  ;  the  length,  however,  varying,  according  to 
the  purposes  for  which  it  is  employed. 

Application. — Place    the  centre  of  the  cravat  upon  the  tendo 
FIG.  110.  Achillis,  just  above  the  ankle  joint,  having 

the  dorsal  surface  of  the  foot  towards  you; 
then  bring  the  two  extremities  of  the  cravat 
forwards,  crossing  them  upon  the  front  of  the 
tibio-tarsal  articulation,  i';  carry  the  two 
ends  downwards  to  the  plantar  surface  of 
the  foot,  recrossing  them  to  carry  them  up, 
2,  2',  in  front  of  the  malleoli,  and  under  the 
crossed  extremities,  1,1';  then  bring  them 
downwards,  as  3,  3',  to  fasten  as  required. 

Variety. — Instead  of  putting  the  courses 
2,  2',  beneath  the  crossed  extremities,  1,1', 
from  below  upwards,  carry  them  up  across 
these  courses,  and  pass  them,  from  above 
downwards,  beneath  the  courses  1,1';  afterwards  make  a  final 
fastening  as  desired. 

Uses. — For  extension  of  the  lower  extremity,  as  in  dressing 
fractures  ;  the  counter-extension  being  made  by  the  perinseal  band, 
or  inclination  of  the  bed. 


M.  Gerdy's  Extension  Knot. 


17 


126  CAIAPLASMATA. 


CHAPTER    XIII. 
UPON    CATAPLASMATA. 

CATAPLASMA  CAKBONIS—( C'AarcoaZ  Poultice). 

Formula.* — Take  of  wood  charcoal,  in  powder,  one-half  an  ounce  ; 
bread  crumbs,  two  ounces ;  linseed  meal,  one  and  one-half  ounces ;  boiling 
water,  ten  fluid-ounces.  After  macerating  the  bread  in  the  water  for  ten 
minutes  before  the  fire,  mix  well,  and  then  gradually  add  the  linseed  meal, 
and  intimately  incorporate  this  with  the  mass.  To  this  add  one-half  the  char- 
coal, stirring  it  well  in,  and  then  sprinkle  the  remaining  charcoal  upon  the 
surface  of  the  cataplasma,  when  spread. 

The  bread  is  not  a  necessary  ingredient  of  this  poultice,  though 
advised  by  the  Pharmacopceia.  It  is  quite  as  well  if  dispensed  with, 
and  the  poultice  is  so  made  by  most  American  dressers. 

If  the  water  is  taken  at  the  temperature  of  boiUng,  as  the  Phar- 
macopoeia recommends,  the  poultice,  when  spread,  is  generally  of  as 
sufficiently  high  temperature  as  the  part  can  well  stand.  Should  the 
poultice  have  become  cool,  however,  it  should  be  heated  by  placing 
upon  a  stove,  hot-air  or  steam-pipes. 

Uses. — In  a  general  way  all  poultices  have  the  same  use ;  that 
of  retaining  warmth  and  moisture  to  a  part,  thus  accelerating  slough- 
ing and  the  discharge  of  inflammatory  products ;  also  that  of  pro- 
tecting the  surface  from  the  air,  and  changes  of  temperature.. 
Besides  these  more  general  uses,  each  kind  may  have  a  specific 
purpose  of  its  own,  as  in  case  of  the  poultice  under  consideration. 
A  charcoal  poultice  is,  in  fine,  an  antiseptic  and  disinfective  poultice. 
The  Pharmacopceia  has  recommended  wood  charcoal ;  animal  is  still 
better,  as  it  has  greater  power  for  absorbing  the  infecting  material 
thrown  off  in  the  slough.  It  prevents  noisome  odors  from  foul,  or 
gangrenous  surfaces,  by  absorbing  the  gases.  It  must  be  frequently 
appUed,  and  should  be  used  in  all  cases  of  gangrenous  ulceration. 


*ISroTE. — The  Formulae  of  most  of  these  cataplasms  are  taken  from  the 
British  Pharmacopceia. 


MANUAL    OF  BANDAGING.  127 

CATAPLASM  A  CONII—(  SemZoc^  Poultice). 

Formula. — Take  of  powdered  hemlock  leaves,  one  ounce ;  linseed  meal, 
three  ounces ;  boiling  water,  ten  fluid-ounces.  Mix  the  hemlock  and  meal 
intimately  together,  and  then  gradually  add  the  water,  constantly  stirring. 

Uses. — As  an  anodyne  dressing  for  cancerous  and  syphilitic 
ulceration.  As  there  is  danger  of  the  drug  being  absorbed  too  freely 
from  the  wounded  surface,  the  patient  should  be  watched  closely 
that  no  poisonous  symptoms  may  arise. 

Opium  and  Belladonna  may  also  be  made  use  of  in  making  these 
anodyne  dressings,  using  them,  however,  in  much  smaller  amounts 
than  is  recommended  to  be  taken  of  the  conium. 

CATAPLASMA   FERMENTI  [Yeast  Poultice). 

FoRMXJiiA. — Take  of  beer  yeast,  six  fluid-ounces ;  wheat  flour,  fourteen 
ounces;  water  (100°  F.),  six  fluid-ounces.  Mix  the  yeast  with  the  water,  and 
stir  in  the  flour,  afterwards  placing  the  mass  before  the  fire  till  it  rises. 

Uses. — As  a  sort  of  an  anodyne  poultice.  The  carbonic  acid 
gas  evolved  has  something  of  an  anaesthetic  effect  upon  the  inflamed 
skin.  It  corrects  the  fetor  of  the  discharges,  and  stimulates  indolent 
ulcers.     The  dressing  is  not  now  much  made  use  of. 

CATAPLASMA  lA'El— {Linseed  Meal  Poultice). 

Formula. — Take  of  linseed  meal,  four  ounces ;  olive  oil,  one-half  of  a 
fluid-ounce ;  boiling  water,  ten  fluid-ounces.  Mix  the  meal  gradually  with 
the  water,  constantly  stirring  it,  and  then  gradually  add  the  oil. 

Uses. — As  a  general  emollient  dressing.  The  Pharmacopczia 
recommends  the  incorporation  of  oil  in  the  cataplasma,  because  it 
is  understood  that  the  "  pressed  "  meal  is  to  be  used.  If  the  un- 
pressed  meal,  which,  perhaps  is  best,  is  employed,  the  oil  is  un- 
necessary. 

This  poultice  may  be  made  anodyne,  antiseptic  or  stimulating, 
just  as  the  surgeon  may  fancy,  by  the  addition  of  drugs  producing 
these  several  effects. 

CATAPLASMA  SINAPIS— (ilfMstord  Poultice). 

Formula. — Take  of  powdered  mustard-seed  and  linseed,  each,  two  and 
one-half  ounces ;  boiling  water,  ten  fluid-ounces.  Mix  the  linseed  meal 
gradually  with  the  water,  and  then  stir  in  the  mustard. 

Uses. — More  especially  as  a  rubefacient.  The  Pharmacopaia 
has  directed  that  boiling  water  be  used.     It  would  be  better  not  to 


128  CATAPLAS3fATA. 

employ  water  at  so  high  a  heat,  as  it  deteriorates  its  rubefacient 
power  in  some  varieties  of  mustard.  The  laity  often  make  an  addi- 
tion of  vinegar ;  but  this  is  a  mistake,  in  case  the  black  mustard  be 
used,  as  it  defeats  the  very  action  it  was  put  in  to  enhance. 

Care  should  also  be  had  in  the  application  of  this  rubefacient  to 
the  very  young  or  very  aged ;  for  if  left  too  long  applied,  epidermal 
sloughing  may  occur. 

CATAPLASM  A  SOBJE  CB.LO'Rm  AT  JE~{Chlorine  Poultice). 

Formula. — Take  of  solution  of  chlorinated  soda,  two  fluid-ounces ;  lin- 
seed meal,  four  ounces ;  boiling  water,  eight  fluid-ounces.  Mix  the  linseed 
meal  gradually  with  the  water,  then  add  the  solution  of  soda,  with  constant 
stirring. 

Uses. — This  is  properly  a  disinfectant  application,  and  makes 
most  an  excellent  dressing  for  foul  and  gangrenous  ulcers. 

Carbolic,  or,  perhaps  be'tter,  Salicylic  acid,  is  a  useful  adjuvant 
to  the  common  linseed,  and  bread-and-milk,  poultices,  having  both 
an  antiseptic  and  disinfectant  action,  besides  a  therapeutical  and 
anaesthetical  one.  Tar  is  also  sometimes  incorporated  in  these 
styles  of  dressings,  and  makes  an  important  ingredient,  in  a  certain 
class  of  eczematous  cases. 

CATAPLASMA  PANIS   ET   J.ACTlS—Bread-and-Milk  Poultice). 

Description. — Take  the  inside  of  a  loaf  of  stale  bread,  crumble 
it  well  up  in  eight  or  ten  ounces  of  sweet  milk,  and,  after  soaking  a 
few  minutes,  let  it  come  to  a  boil,  and  then  stir  in  a  bit  of  lard,  or  a 
few  drachms  of  sweet  oil. 

Uses. — As  an  emollient  dressing.  Anodynes  may  be  added  as 
suits  the  case.  Is  not  a  very  commendable  poultice,  as,  from  the 
heat,  etc.,  of  the  inflamed  part,  the  milk  soon  becomes  rancid. 

POULTICE  OF  OAKUM. 

Description. — Take  a  sufficient  quantity  of  oakum,  loosely 
picked,  and  place  in  a  thin  piece  of  muslin  and  wrap  loosely  up; 
then  immerse  the  whole  in  boiling  water.  It  is  then  wrung  out  and 
covered  by  a  thin  layer  of  muslin,  and  is  thus  to  be  applied  to  the 
member  diseased. 

Uses. — As  an  antiseptic  and  absorptive  dressing.  The  water 
may  be  charged  with  antiseptics  or  anodynes. 


MANUAL    OF  BANDAGING.  129 

HOW   TO   SPEEAD  A   POULTICE. 

The  batter  of  the  poultice  having  been  prepared,  it  is  necessary 
to  have  a  piece  of  thick  cotton  cloth,  or  linen,  two  or  three  inches 
wider  than  the  surface  you  wish  to  cover  with  the  cataplasma. 
Spreading  this  smoothly  out  upon  a  flat  surface,  you  pour  the  batter 
upon  it,  and  with  a  spatula  you  spread  it,  to  a  proper  thickness, 
evenly  over  the  cloth,  having  care  that  it  does  not  come  to  within 
an  inch  or  two  of  its  edge.  You  then  fold  each  edge  of  the  cloth 
evenly  over  the  edge  of  the  applied  batter,  thus  leaving  a  clean,  neat 
margin  to  your  cataplasm,  as  well  as  effecting  a  sort  of  a  confine- 
ment of  the  batter  to  the  cloth.  You  now  spread  a  very  thin  piece 
of  muslin  (the  thinner  the  better)  over  the  whole  surface  of  the 
poultice  ;  this  prevents  any  of  the  meal  from  drying  upon  your 
patient's  person,  and  ensures  him  a  neat,  clean  and  comfortable 
dressing. 

Some  surgeons,  however,  prefer  a  coating  of  sweet  oil  over  the 
spread  poultice-batter  to  the  thin  piece  of  muslin.  This  also  keeps 
the  meal  from  adhering  to  the  skin. 

HOW   TO  APPLY  A  POULTICE. 

Everything  being  in  readiness,  the  poultice  is  lifted  from  the 
table,  and  one  end  gently  laid  upon  the  tender  and  inflamed  surface, 
and  the  remainder  of  the  poultice  suffered  gradually  to  cover  over 
the  diseased  member  ;  with  this  little  care  you  will  often  save  your 
patient  much  needless  pain  and  suffering,  that  would  else  be  caused 
by  "  slapping"  your  dressing  upon  a  tender  and  sensitive  part.  The 
same  gentleness  should  be  used  in  lifting  a  poultice ;  otherwise, 
from  the  quick  relief  of  pressure,  a  severe  throbbing  pain  will  ensue. 

After  the  cataplasm  has  been  properly  placed,  it,  and  a  portion 
of  the  member,  should  be  covered  with  a  piece  of  oil-silk,  thin 
table  oil-cloth,  or  oiled  muslin,  and  over  this  should  be  thrown  a 
layer  or  so  of  flannel,  the  whole  finally  being  lightly  confined  by  a 
proper  bandage.  The  oiled  silk,  or  muslin,  serves  a  double  purpose ; 
that  of  confining  the  heat  or  moisture  to  the  part,  and  of  protecting 
the  bed  clothes,  or  clothing,  from  the  water  in  the  poultice-batter. 


ii^iDEx:, 


Arm-sling,  ordinary,  69. 

Bandages  in  general,  19. 
•      classification  of,  24. 

regional  classification  of,  25. 

compound,  25. 

simple,  25. 

of  the  head,  26. 

of  the  neck,  47. 

of  the  upper  extremity,  54. 

of  the  body,  72. 

of  the  lower  extremity,  86. 
Binocle,  29. 
Boulette,  14. 
Bourdonnet,  14. 
Bavarian  plaster  splint,  112. 
Bonnet,  triangular,  of  the  head,  31. 
of  the  nates,  108. 
Bourse  of  the  mamma,  79. 

of  the  scrotum,  110. 


Capote,  110,  120. 
Caputina,  99. 
Cataplasma  carbonis,  126. 

conii,  127. 

fermenti,  127. 

lini,  127. 

suiapis,  127. 

sodse  chlorinatse,  128. 

pauis  et  lactis,  128. 

how  to  spread  a,  129. 

how  to  apply  a,  129. 
Charpie,  13. 
Circular  of  the  forehead  and  eyes,  26. 

of  the  neck,  47. 
Circular- quadrilateral   of  the  chest,    and 
dorsal  cervico-stemal  triangle,  73. 

of  the  abdomen,  and  the  dorsal  cer- 
vico-sternal  triangle,  74. 

of  the  abdomen  and  thorax,  and  the 
dorsal  cervico-sternal  triangle,  74. 
Common  plaster  dressing,  114. 
Compresses,  16. 

button-hole,  17. 

circular,  16. 


complex,  17. 

graduated  pyramidal,  16. 
graduated  regular,  16. 
perforated,  17, 
rectangular,  16. 
sling,  17. 
square,  16. 
triangular,  16. 
of  two  heads,  17. 
of  three  heads,  17. 
of  four  heads,  17. 
of  six  heads,  17. 
Cotton-wool,  13. 
Cravat,  cervical,  47. 
carpo-olecranon,  64. 
cervico-ulnar,  and  triangle,  66. 
of  the  neck  and  axilla,  75. 
simple  biaxillary,  77. 
compound  biaxillarj',  77. 
simple  dorsal  biaxillary,  82. 
compound  dorsal  biaxillary,  82. 
simple  sternal  biaxUlary,  84. 
compound  sternal  biaxillary,  85. 
popliteal,  90. 
of  the  knee,  90. 
tarso-patellar,  100. 
tarso-crural,  101. 

taiso-pelvic,  102. 

Gruro-  pelvic,  106. 

inguinal,  106. 

sacro-bicrural,  106. 

perinaeal,  107. 
Cross,  Maltese,  20. 

of  the  eye,  28. 

of  the  eyes,  29. 

simple,  of  the  chin,  32. 

of  the  head,  34. 

of  the  head.  Mayor's,  38. 

posterior,  of  the  head  and  neck,  45. 

of  the  occiput,  45. 

of  the  mamma,  78. 

of  the  two  mammae,  80. 

of  the  groin,  103. 

Emplastrum  resiuae,  117. 

Fenestrated  immovable  dressings,  116. 


INDEX. 


131 


rigure-of-8,   posterior,   of  the   head  and 
axillae,  47. 

anterior,  of  the  head  and  axillse,  49. 

of  the  head  and  axilla,  52. 

posterior,  of  the  hand  and  wrist,  55. 

anterior,  of  the  hand  and  wrist,  56. 

extensor  of  the  hand  upon  the  fore- 
arm, 63. 

flexor  of  the  hand  upon  the  forearm,  63 

anterior,  of  the  elbow,  65. 

posterior,  of  the  elbow,  66. 

posterior,  double,  of  the  elbow  and  op- 
posite axilla,  70. 

of  the  neck  and  axilla,  75. 

of  the   shoulder   and  the   opposite 
axilla,  76. 

posterior,  of  the  shoulders,  81. 

anterior,  of  the  shoulders,  83. 

of  one  toe,  86. 

of  the  foot  and  ankle,  87. 

posterior,  of  the  knee,  89. 

anterior,  of  the  knee,  9i). 

spiral,  of  the  extremities,  93. 

bandage,  of  the  extremities,  94. 
Fillet,  or  head-band,  27. 
Four-tailed  bandage  of  the  chin,  33. 

of  the  head  and  neck,  46. 

of  the  hand,  57. 

of  the  elbow,  66. 

of  the  shoulder,  68. 

of  the  instep,  88. 

of  the  heel,  88. 

of  the  leg,  95. 

of  the  knee,  92. 

of  the  hip,  108. 
Front,  triangular,  of  the  forearm,  69. 

small,  of  the  hand  or  forearm,  69. 

Gateau,  13. 

Gauntlet,  of  the  hand,  61. 
of  the  foot,  86. 

Handkerchief  bandage,  41. 
Harelip  bandage,  48. 
Head-band,  27. 
Mayor's,  30. 

Immovable  dressings,  112. 
Invaginated  roller,  of  the  upper  lip,  43. 

of  the  under  lip,  44. 
Invaginated  triangle,  of  the  upper  lip,  45. 

of  the  under  Up,  45. 

Knot,  surgeon's,  123. 

reef,  123. 

"  granny,"  123. 

clove-hitch,  124. 

M.  Gerdy's  extension,  125. 
Knots,  123. 
Knotted  bandage^of  the  head,  36. 


Lateral  bandage  of  the  neck,  52. 
Maltese  cross,  20. 

for  thigh  stump,  98. 

for  leg  stump,  99. 

for  arm  stump,  99. 
Monocle,  28. 

Parrafin  bandage,  116. 

Peiete,  14. 

Plaster,  adhesive,  117. 

bandage,  Pirogofifs,  114. 
Plumasseau,  13. 
Posterior  "  star  "  bandage,  81. 
Poultice,  charcoal,  126. 

hemlock,  127. 

yeast,  127. 

linseed  meal,  127. 

mustard,  127. 

chlorine,  128. 

bread-and-milk,  128. 

oakum,  128. 

how  to  spread  a,  129. 

how  to  apply  a,  129. 

Recurrent  bandage,  of  the  head,  .39. 

for  amputated  thigh,  97. 

for  amputated  leg,  97. 

for  amputated  forearm,  97. 

for  amputated  arm,  97. 
Reverses,  how  to  make,  22. 
RoUer,  a,  20. 

how  to  make,  21. 

how  to  apply,  22. 

how  to  confine,  23. 

of  the  chin,  32. 

invaginated,  of  the  upper  lip,  43. 
of  the  under  lip,  44. 

of  the  superior  extremity,  65. 

cap  of  the  knee,  91. 
Rosette  stump  dressing,  99. 

Sheath,  of  the  fingers,  62. 

of  the  foot,  80. 
Silica  bandage,  116. 
Six-tailed  bandage  of  the  head,  40. 
Skull-cap,  26. 
Sling,  of  the  face,  27. 

of  the  chin,  33. 

of  the  head,  40. 

of  the  occiput,  66. 

of  the  hand,  57. 

large,  triangular,  of  the  arm,  68. 

small,  of  the  hand  or  forearm,  69. 
of  the  instep,  89. 
of  the  heel,  88. 

for  the  superior  extremity,  103. 
Spica,  of  the  shoulder,  75. 

descending,  of  the  shoulder,  76. 

ascending,  of  the  shoulder,  76. 

of  the  toes,  86. 


132 


INDEX. 


ascending,  of  the  groin,  103. 

descending,  of  the  groin,  104. 

of  the  thumb,  55. 
Spiral,  of  the  neclv,  47. 

of  one  finger,  54. 

of  all  the  fingers,  61. 

of  the  fingers  and  the  hand,  62. 

simple,  of  the  forearm,  65. 

reversed,  of  the  superior  extremity,  65. 

of  the  arm,  67. 

of  the  chest,  72. 

of  the  abdomen,  73. 

of  one  toe,  86. 

of  all  the  toes,  86. 

of  the  foot,  87. 

of  the  knee,  91. 

simple,  of  the  leg,  92. 

of  the  thigh,  92. 

reversed,  of  the  leg,  93. 

ofthethiph,  93. 

figure-of-8,  of  the  extremities,  93. 

reversed,  of  the  inferior  extremity,  96. 
Starch,  or  plaster,  roller,  115. 
Strappings,  117. 

for  the  foot  and  anlile,  118. 

for  wounds,  119. 

for  the  testicle,  120. 

for  the  breast,  121. 

for  extension  of  the  leg,  122. 
Suspensory  bandage  of  the  scrotum,  109. 


T    of  the  head  and  ear,  36. 
of  the  temple,  36. 

perforated,  of  the  head  and  ear,  37. 
double,  of  the  nose,  41. 
ofthe  mouth,  42. 
double,   posterior,   of  the   head   and 

thorax,  49. 
double,   anterior,   of  the    head    and 

thorax,  50. 
double,  of  the  bacli  ofthe  hand  and 

wrist,  57. 
single,  of  the  back  of  the  hand  and 

wrist,  58. 
perforated,  of  the  hand  and  wrist,  59. 


double,  anterior,  of  hand  and  wrist,  60. 

single,  anterior,  of  hand  and  wrist,  60. 

double,  ofthe  toes  and  ankle,  86. 

trapezoidal,  of  the  groin,  104. 

double,  ofthe  perineeum,  107. 

single,  ofthe  perinaeum,  107. 

double,  of  the  trunk.  111. 
Tampon,  14. 
Temple  bandage,  34. 
Tents,  14. 

Testudo  of  the  knee,  91. 
Triangle,  ofthe  face,  29. 

ofthe  eye,  29. 

fronto-oculo-occipital,  30. 

fron to-occipital,  31. 

occipito-frontal,  31. 

biparietal,  .31. 

occipito-mental,  .34. 

of  the  chin,  34. 

occipito-auricular,  38. 

ofthe  head,  41. 

fronto-cervico-labial.  45. 

fronto-dorsal,  49. 

occipito-sternal,  51. 

parieto-axillary,  and  cravat,  52. 

lateral,  ofthe  neck,  .52. 

carpo-digito-palmar,  59. 

carpo-digito-dorsal,  60. 

of  the  elbow,  66. 

large  oblique,  of  the  arm  and  chest,  68. 

anterior,  thoracico-scapular,  74. 

posterior,  thoracico-scapular,  74. 

ofthe  mamma.  79. 

bimammary,  81. 

ofthe  foot,  88. 

of  the  leg,  95. 

for  thigh  stump,  98. 

for  leg  stump,  98. 

for  arm  stump,  98. 

scapulo-tibial,  and  cravat,  102. 

crv(ro-inguinal,  105. 

cruro-pelvic,  105. 
■    sacro-pubic,  108. 

coxo-pelvic,  108. 

lumbo-scrotal,  109. 
Tubes  caoutchouc  vulcanise,  110, 120. 


ADYEKTISEME^TS. 


SHEPARD  &  DUDLEY 

Importers,  Manufacturers  and  Wholesale  Dealers  in 
MANUFACTURERS  OF 

Elastic  Goods.  Supporters,  Chest  Protectors,  Etc. 

iBstrnent  Makers  to  the  New  Yorl  Eye  M  Ear  Inflrinary. 

150  William  Street, NEW  YORK. 


Copy  of  the  Judges'  Report,  in 
Department  III,  Group  5,  Div.  A, 
at  the  43d  Exhibition  of  the 
American  Institute,  held  in  the 
City  of  New  York,  October  and 
November,  1874  : 


SURGICAL  INSTRUMENTS  AND  APPLIANCES. 

SHEPARD  &  DUDLEY,  150  William  Street,  New  York. 

We  heartily  concur  in   commending  this  case  of  Surgical  Instruments  and 

Appliances,  as  being  decidedly  valuable,  excellent  in  manufacture,  equal 

to  the  best  of  its  class  known,  reflecting  great  credit  on  the  exhibitors. 

A  SILVER  MEDAL  AWARDED. 


Heney  B.  Sands,  M.  D.,  Prof,  of  Anatomy  in  the  College  of  Physicians  and  Surgeons, 
Surgeon  to  Rosevelt  an(J  Bellevue  Hospitals,  New  York. 

Edward  D.  Janewat,  M.  D.,  Lecturer  on  Materia  Medica  and  Therapeutics,  and  Clinical 
Medicine,  and  Physician  to  Bellevue  Hospital. 

T.  P.  GiBNEY,  M.  D..  Surgeon  to  the  Hospital  for  Ruptured  and  Crippled,  New  York. 


sBiiasa'-^o»°''®^ 


Yon  Braun's  Starch  Bandage  Shears  for  Removing  any  Immovable  Dressings. 


iF'ie.EiDEi^icic  STEj^i^nsrs, 


AISTD     IjVtFORXER,    OF 

MEDIGM  MERGHM\IDISE. 

DEPOT  FOR  AMERICAN  DRUGS  AND  THEIR  PRODOCTS, 

DETROIT,   ---   MICHIGAN. 

WAREHOUSE    No.    89    ^WOODWARD    AVENUE, 

Laboratory  and  Drug  Mills,  Woodbridge  and  Congress  Sts,.  bet.  Fifth  and  Sixth, 


The  following   NEW   DRUGS   are   ofiered, 
EXTRACT,  ELIXIR, 

JABORANDI 

The  new  and  intensely  powerful  sialo- 
gogue  and  sudorific. 

GRINDELIA 

The  new  Californian  specific  for  Asthma 
and  Bronchitis. 

BOLDO 

Leaves  of  a  Chilian  evergreen,  used  as 
an  alterative  in  liver  diseases,  tonic  in 
fevers. 

CHIONANTHUS 

A  valuable  tonic,  aperient  and  altera 
tive  in  bilious  and  intermittent  fevers. 

CAINCA 

Brazilian  diuretic,  for  dropsy. 

C  AST  AN  E  A 

Sweet  chestnut  leaves,  used  in  whoop- 
ing cough. 

FUCUS  VESICULOSUS 

Used  for  reducing  obesity. 

MALT    (EXTRACT) 

Diastase,  milk,  malt-sugar  and  alkaline 
salts.    Nutritious  tonic. 

RICINUS,  FOLIA 

Galactagogue,  inducing  the  flow  of 
mother's  mUk  when  absent. 

SILPHIUM 

Compass  plant,  valuable  tonic  and  alter- 
ative. 


Crude  or  Powdered,  and  in  form  of  FLUID 
SYRUP  or  TINCTURE. 

DAMIANA 

The  new  aphrodisiac  from  Mexico,  re- 
puted reliable  for  restoring  virility. 

I  GUARANA 

New  South  American  drug,  used  in 
headache,  neuralgia,  dysentery,  nervous 
depression,  etc. 

CEREUS  GRANDIFLORUS 

Flowers  of  the  night  blooming  cereus, 
used  in  functional  palpitation  of  the 
heart.  (In  fluid  extract  and  tincture,  only). 

CALENDULA 

Flowers — Anti-spasmodic. 

EUCALYPTUS 

Used  in  intermittents,  and  as  an  aroma- 
tic anti;eptic. 

G-UACO 

A  Venezuela  plant,  reputed  of  value  as  a 
diaphoretic  in  cholera,  yellow  fever,  etc. 

KAMALA  AND  KOUSSO 

Abyssinian  anthelmintics,  used  for  ex- 
pelling tape  worm. 

CENOTHERA 

Evening  primrose.  Alterative  in  skin 
diseases. 

RHAMNUS  FRANGULA 

Bark  of  black  buckthorn,  valuable  ca- 
thartic and  aperient. 

SUMBUL 

The  Bucharian  musk  root,  is  a  nervous 
anodyne  in  delirium,  hysteria,  gastric 
spasms,  etc. 


Catalogue  No  75,  a  comprehensive  Priced  list,  132  Pages,  168  Classes, 

comprising  about  10»  000  Pharmaceutical  products,  will  be  sent  to  any  address  for 
25  cents. 


Fluid  Extracts, 420  kinds. 

Pills,  Sugar  Coated, 404      " 

EUxirs, 212      " 

Solid  Extracts 670      " 


Pressed  American  Herbs  etc. 


I  kinds. 


Medicated  Lozenges, 212  kinds. 

Resinous  Substances, 220     " 

Suppositories, 121  kinds,  5  sizes. 

Powdered  Drugs, 823    sorts. 

Miscellaneous  Products,  over  7,000  kinds. 


L.  BLACK  &  CO., 
Manufacturing  Opticians, 

77  Woodward  Avenue,  DETROIT,  MICH. 

Microscopes  and  Slides, 

Fever  Thermometers, 
Artificial  Eyes, 

Cataract  Lenses, 
Magnifiers,  Loupes, 
Opthalmascopes,    Test   Tubes, 
Philosophical  Apparatus, 
Electric  Batteries,  etc.,   etc. 

Spectacles  and  Eyeglasses  fitted  and  adjusted  to  the  failing  Eyesight. 
Orders  by  mail  will  receive  prompt  attention. 

lu.    BLACIt     &,    OO. 

Established    jL.    JL).    1843. 


W.  B.  KEEI^,  OOOKE  &  CO., 
PUBLISHERS,   BOOKSELLERS  AND  STATIONERS, 

C  EC  I  O  -A.  a-  o. 

Medical  and  Surgical  Publications. 

TO  THE  MEDICAL  PROFEiSSION. 

W.  B.  KEEN,  COOKE  &  CO.'S  MEDICAL  BOOK  DEPARTMENT  is  the  most 
extensive  in  the  country.  Particular  attention  is  called  to  our  catalogue  of  Medical  Books 
which  will  be  mailed  Free  on  application. 

HOW  TO  PROCURE  BOOKS.— We  will  forward  per  U.  S.  Mail  and  prepay  postage 
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pounds  are  not  mailable),  upon  receipt  of  Publishers'  Prices,  as  named  in  our  Catalogue. 

4i®="'VVe  assume  no  risk  upon  Money  or  Books,  although  out  of  the  many  hundreds  of 
volumes  sent  by  us  by  mail,  none  to  our  knowledge  have  been  lost. 

We  will  forward  Books  to  all  points  reached  by  the  Regular  Express  Lines,  east  of 
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freight  and  of  returning  the  money,  must  be  paid  by  the  consignee. 

CHICAGO  MEDICAL  JOURNAL  AND  EXAMINER. 

Editor :  William  H.  Byford,  A.M.,  M.D.  Associate  Editors :  James  H.  Etheridtre  M  D 
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Orders  by  IMail  ^vill  receive  prompt  attention.  M-edical 
and.  ]yiiscellaneovis  Boobs  mailed  post-paid  on  receipt  of 
retail  price  or  by  Express  at  th.e  discounts  above,  charges 
being  paid  by  Consignee. 

FARRAND,  WILLIAMS  &  CO.'S 

COD  LIYEE  OIL 

Is  put  up  in  pint  bottles,  with  our  firm  name  on  the  labels  and  over  each  cork.  The  oil 
is  imported  from  Norway  in  tin  lined  and  perfectly  air  tight  barrels.  It  is  made  with 
scientific  care  at  a  low  temperature,  in  order  to  insure  its  paleness,  sweetness,  and  free- 
dom from  unpleasant  ilavor.  The  delicacy  and  purity  thus  obtained,  render  it  especially 
valuable  to  the  invalid.  A  careful  observation  has  convinced  us  that  the  oil  yielded  by 
the  Codfish  of  the  Norwegian  Seas  is  preferable,  in  point  of  palatableness  and  medicinal 
properties,  to  the  Oil  of  Newfoundland,  and  this  opinion  has  been  confirmed  by  the  re- 
cent tendency  of  medical  and  popular  selection.  It  contains  less  solid  fats,  or  stearine, 
and  is  therefore  digested  bv  delicate  stomachs,  which  cannot  tolerate  the  coarser  Oils 
which  are  put  upon  the  market. 

THE  NORWEGIAN  00 D  LIVER  OIL 

Costs  to  import  just  double  the  price  of  Newfoundland  Oil,  yet  we  sell  the  former  in  bot- 
tles at  as  low  price  as  the  latter  is  sold  for,  and  in  doing  so,  we  feel  that  we  are  confer- 
ring a  boon  upon  the  public. 

If  the  medical  profession  will  designate  our  Oil  in  their  prescriptions,  it  will  give  their 
patients  satisfaction,  and  they  can  rest  assured  that  the  Oil  is  inferior  to  none. 


F^iE^i^-i^isriD,  -v^ixjXjIj^i^^s  &c  00., 

MANUFACTUREES    OP 

MEDICINAL   ELIXIRS.   MEDICATED   TINCTURES,  SYRUPS, 

ESSENCES,  WATERS,   OINTMENTS,  PLASTERS, 

All  Warranted  Officinal  Strength. 

Dealers  in  and  Importers  of  Pure  Chemicals,  Fine  Powdered  Drugs,  Shaker's 

Herbs,  Gums,  Pure  Essential  Oils,  Etc. 

(^"Purity  and  Quality  are  always  of  the  First  Consideration  with  us  in  buying  and 
selling. 


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